The  Home  Dietitian 


or 


Food  and  Health 


THE  AUTHOR  AND  HER  SONS 


:<iiimimiimiimiimmiiiim inn iiiiiiiiiiiiiniiiiiiiin 


mi hiiiiiiii.u. ii'iinui -1111,1 IMI.II.IIIIUIIII imiiiiimiiiMiir. 

•  •    •    .      ,    :,  •'   ,  = 

s 

I 

The  Home  Dietitian 


or 


Food  and  Health 

1 

Scientific    Dietetics 
Practically  Applied 


By 
BELLE  WOOD-COMSTOCK,  M.  D. 


Member  of  the  Los  Angeles  County  Medical  Society, 
of  the  Los  Angeles  Obstetrical  Society,  and  of 
the  Professional  Woman's  Club  of  Los  Angeles 


REVIEW  AND  HERALD  PUBLISHING  ASSOCIATION 
TAKOMA  PARK,   WASHINGTON,  D.  C. 

SOUTH   BEND,    IND.  PEEKSKILL,  N.   Y. 


Printed  in  U.  S   A. 


•is*  i 


Copyrighted  1919  and  1922 

by 
BELLE  WOOD-COMSTOCK,  M.  D. 


a 

c 


INTRODUCTORY  NOTE 

MENDEL  says :  "  Let  us  welcome  the  day  when  the  food 
market  and  the  kitchen  are  taken  into  consideration  by 
the  physician  as  seriously  as  are  the  apothecary  shop  and 
the  fashionable  watering  place." 

When  people  eat  the  proper  kind  and  amount  of  food 
in  the  proper  way,  there  will  be  little  need  for  the 
physician  except  as  a  teacher  and  guide.  Today  the 
people's  greatest  need  is  education  in  normal  living. 
Little  good  can  come  from  spasmodic,  desultory  teaching. 
The  mother,  the  housewife,  must  be  thoroughly  trained 
in  the  science  of  home-keeping  and  child  culture,  a  most 
important  phase  of  which  is  the  feeding  of  the  bodies  of 
those  in  her  care. 

"  What  the  average  woman  at  the  head  of  a  home 
does  not  sufficiently  grasp  in  all  its  importance,  is  that 
the  very  center  of  the  household  —  the  most  important 
thing  in  the  home  —  is  the  spread  table  with  a  meal  on 
it.  Look  at  the  church.  It  is  by  no  accident  or  mere 
coincident  that  the  central  sacrament  of  the  Christian 
religion  takes  the  form  of  a  common  meal.  It  repre- 
sents a  universal  fact  of  human  life.  The  domestic 
table  is  really  the  pivot  upon  which  the  whole  home 
turns."  —  Elizabeth  Harrison. 

"  The  body  is  the  foundation  and  not  to  be  ignored. 
The  people  of  power  are  those  who  have  an   efficient 
tool   to   carry   out  the   mental   and   spiritual   ideas." 
Dickenson. 

The  mother  has  the  opportunity  of  developing  in  her 
child  the  physical  foundation  that  makes  possible  heights 

4969!*  i  5 


of  intellectual  and  spiritual  growth.  The  problem  must 
be  solved  in  the  home.  Upon  the  housewife  rests  the 
responsibility.  To  her  this  book  is  humbly  dedicated  in 
the  hope  that  it  may  help  her  in  her  task. 

BELLE  WOOD-COMSTOCK. 


"  In  the  years  of  infancy  and  childhood,  food 
and  nourishment  are  of  special  moment;  not 
alone  for  the  time,  but  also  for  the  child's  future 
life.  Through  its  diet  a  child  may  grow  up  to 
be  —  in  the  business  of  life  —  idle  or  indus- 
trious, dull  or  lively,  weak  or  strong." —  Froebel. 

"  Experiments  have  shown  that  physical  en- 
durance can  be  doubled  by  dietetic  causes  alone." 
—  Fisher. 


INTRODUCTION  TO  SECOND  EDITION 

THE  favorable  reception  accorded  the  first  edition  of 
"  The  Home  Dietitian "  has  been  very  gratifying,  and 
is  much  appreciated. 

Experimental  work  during  the  last  few  years  has 
settled  in  an  undebatable  way  many  questions  which  for 
centuries  were  hidden  in  a  maze  of  uncertainty  and  su- 
perstition. The  question  of  nutrition  no  longer  rests 
upon  theory  or  conjecture,  but  has  been  placed  on  an 
undeniably  safe  scientific  basis.  Much  is  still  not  fully 
understood;  many  questions  are  yet  to  be  answered, 
many  details  to  be  worked  out;  but  the  maze  of  uncer- 
tainty has  been  cleared  away,  and  careful  research  sim- 
ply serves  to  establish  more  firmly  certain  definite  basic 
principles. 

The  calorie,  at  first  received  with  great  respect  as  the 
solution  to  all  food  problems,  then  by  many  set  aside  as 
of  little  value,  is  now  accorded  its  proper  place  in  the 
mathematics  of  nutrition.  The  vitamine,  that  vague 
something  only  recently  viewed  askance  by  the  con- 
servative investigator,  has  been  established  as  a  definite 
entity,  to  be  ignored  only  at  the  risk  of  serious  loss. 

Much  that  is  of  value  has  been  added  to  this  edition; 
nothing  to  neutralize  or  underrate  what  has  been  pre- 
sented before,  but  only  that  which  establishes  more 
firmly  certain  dietetic  principles  which  cannot  be  gain- 
said. 

Somewhat  under  protest,  but  because  of  repeated  de- 
mand for  suggestions  as  to  the  application  of  dietetic 
principles  in  the  feeding  of  the  sick,  we  have  in  this 
edition  added  several  chapters.  These  we  trust  will  be 
helpful  in  the  solution  of  many  feeding  problems  in 

7 


times  of  ill  health  and  disease;  and  assist,  in  a  measure, 
to  remove  from  the  minds  of  the  people  the  idea,  with 
so  many  firmly  fixed,  that  disease  is  something  to  be 
cured  by  a  magic  potion  or  a  mechanical  thrust. 

Our  thought  has  been  to  make  the  way  so  plain  that 
the  everyday  student,  the  parent,  the  child,  might  re- 
ceive in  a  practical  way  the  benefit  of  the  great  work 
done  by  such  men  as  Mendel,  Osborne,  Funk,  McCollum, 
and  others,  who  in  solving  these  problems  have  rendered 
the  greatest  possible  physical  service  to  mankind. 

Those  who  want  arbitrary  dietary  outlines  may  be 
a  bit  disappointed;  but  to  those  who  would,  by  careful 
study,  seek  to  Master  the  simple  underlying  principles 
of  nutrition,  we  offer  this  book,  trusting  that  in  it  they 
may  find  the  problem  simplified. 

THE  AUTHOR. 


"  Isn't  it  queer  that  some  people  care  more 
for  what  they  eat  than  for  hoiv  they  feel?  The 
question  is  not  how  much  good  is  this  food  go- 
ing to  do  me,  but  how  pleasant  it  will  taste 
for  an  instant  while  it  is  passing  through  my 
mouth." — Journal  of  Public  Health. 


TABLE   OF   CONTENTS 

I     Food  Classification ;  the  Cycle  of  Life 11 

II     The  Body  as  a  Stove ;  Metabolism 17 

III  Defective  Food  Analysis;  Auto-intoxica- 

tion    21 

IV  Defective    Food    Analysis    (Continued)  ; 

Suboxidation   27 

V     The  Food  Unit,  or  Calorie 32 

VI     A  Balanced  Ration  —  Protein 38 

VII     A  Balanced  Ration  (Continued)  —  Fat  .  .  49 
VIII     Carbohydrates;  Their  Place  in  the  Daily 

Ration    58 

IX     Vitamines    69 

X     Mineral  Salts 81 

XI     Fruits 92 

XII     Vegetables   99 

XIII  Breads  and  Cereals 109 

XIV  Dairy  Products 116 

XV     Flesh  Food :  Is  It  a  Dietary  Essential?  .  .  124 

XVI     Condiments   140 

XVII     Unnatural  Stimulants   145 

XVIII     Desserts   151 

XIX     Meat  Substitutes  and  Suggestive  Menus .  .  155 

XX     Combinations    172 

XXI     The  Feeding  of  Children   178 

XXII     Fads   189 

XXIII  Food  Economy    198 

XXIV  Vegetarian  Diet  Without  Dairy  Products  205 
XXV     Principles  of  Feeding  the  Sick,  and  Their 

Application  in  Acute  Disease  ....  218 
XXVI     Principles  of  Feeding  the  Sick  as  Applied 

in  Chronic  Constitutional  Diseases  232 
XXVII     Principles  of  Feeding  the  Sick  as  Applied 

in  Chronic  Infectious  Diseases  . .  .  259 

XXVIII     Milk  and  the  Milk  Diet  265 

XXIX     Food  Idiosyncrasies 273 

XXX     Summary  and  Conclusion 281 

XXXI     Recipes  —  Simple,  Economical,  Hygienic  284 
APPENDIX:    Table    I    Caloric   Value   of  Ready-to- 

Serve  Foods 329 

Table  II    Foodstuffs,    Both    Raw    and 

Cooked,  Commonly  Used  in  Cooking  339 


Health  is  a  state  of  physical,  mental,  and 
moral  equilibrium,  a  normal  functionating  of 
body,  mind,  and  soul.  It  is  the  state  when 
work  is  a  pleasure,  when  the  world  looks  good 
and  beautiful,  and  the  battle  of  life  seems 
worth  while.  Health  is  the  antithesis  of  dis- 
ease, degeneracy,  and  crime.  .  .  . 

Health  is  the  most  desired  of  earthly  bless- 
ings. When  finally  lost,  it  cannot  be  purchased 
by  uncounted  millions,  restored  by  the  alienist, 
or  returned  by  the  pulpit. —  S.  J.  Crumbine. 


CHAPTER  I 
FOOD  CLASSIFICATION;   THE  CYCLE  OF  LIFE 

IN  the  body,  combined  in  various  ways,  are  sixteen 
chemical  elements :  carbon,  hydrogen,  oxygen,  nitrogen, 
sodium,  potassium,  magnesium,  calcium,  phosphorus,  iron, 
sulphur,  chlorine,  iodine,  bromine,  fluorine,  and  silicon. 

For  the  successful  growing  of  crops  there  must  be 
present  in  the  soil  a  definite  number  of  elements  in  nor- 
mal amount  and  combination.  Likewise  for  the  normal 
development  of  human  beings,  there  must  be  present  in 
the  food  these  sixteen  elements  in  proper  amount  and 
proportion. 

These  are  not  taken  into  the  body  as  elements,  but 
are  built  up  first  into  seven  elemental  food  classes. 
These  seven  food  classes  are:  carbohydrates,  fats,  pro- 
teins, vitamines,  salts,  cellulose,  and  water.  Any  daily 
food  ration  not  containing  these  in  proper  proportion 
is  defective. 

Food    Elements 

CLASS  I. —  Carbohydrate,  made  up  of  the  chemical 
elements  carbon,  hydrogen,  and  oxygen,  includes  all 
starches  and  sugars,  and  is  a  fuel  food.  Its  combustion 
in  the  body  produces  heat  and  energy.  The  carbohy- 
drates make  up  a  large  part  of  the  food  value  of  grains, 
fruits,  and  vegetables. 

CLASS  II. —  Fat  is  another,  but  more  concentrated, 
fuel  food,  also  containing  carbon,  hydrogen,  and  oxygen. 
This  food  element  we  have  in  butter,  oils,  fat  meats, 
nuts,  egg  yolks,  olives,  the  alligator  pear,  the  soy  bean; 
also  to  some  extent  in  other  legumes,  in  grains,  and  in 
vegetables. 

ll 


12  :    - .'  .    .  THg.  -  HOME'  "DIETITIAN 

CLASS  III. —  Protein  is  the  muscle  and  tissue  builder. 
It  contains,  in  addition  to  carbon,  hydrogen,  and  oxy- 
gen, another  very  important  chemical  element,  called 
nitrogen,  by  reason  of  which  it  is  often  spoken  of  as  ni- 
trogenous food.  Protein  also  contains  variable  amounts 
of  other  chemical  elements,  as  sulphur,  phosphorus,  and 
sometimes  iron,  but  its  distinctive  element  is  nitrogen. 
This  food  is  found  in  a  pure  state  in  egg  white,  in  the 
casein  of  milk,  and  in  lean  meat.  In  a  combined  form 
it  makes  up  part  of  the  food  value  of  grains,  vegetables, 
legumes,  and  nuts. 

CLASS  IV. —  Vitamines,  our  knowledge  of  which  is 
still  somewhat  limited,  are  doubtless  the  substances  out 
of  which  the  body  makes  its  internal  secretions,  diges- 
tive enzymes,  and  the  ferments  of  vegetative  life  proc- 
esses. They  are  found  in  raw  and  fresh  vegetables,  fruit, 
raw  milk,  the  outer  covering  of  grains,  and  raw  meat. 

CLASS  V. —  Salts,  both  organic  and  inorganic,  are 
made  up  of  many  different  chemical  elements,  and  are 
necessary  for  blood  making  and  tissue  building,  for  the 
carrying  on  of  various  metabolic  and  secretory  proc- 
esses, and  for  the  maintenance  of  the  proper  alkalinity 
of  all  body  fluids.  They  are  found  principally  in  fruits, 
vegetables,  grains,  and  milk,  and  are  located  with  the 
vitamines  largely  under  the  skin  of  fruits  and  vege- 
tables and  in  or  near  the  outer  covering  of  grain. 

CLASS  VI. —  Cellulose  is  really  a  carbohydrate,  but 
being  practically  indigestible,  is  placed  in  a  class  by 
itself.  It  makes  up  the  woody  framework  of  fruits  and 
vegetables.  Its  value  is  in  its  bulk,  which  by  its  pres- 
ence prevents  too  great  food  concentration  and  me- 
chanically stimulates  the  bowel,  thus  aiding  in  normal 
intestinal  peristalsis. 

CLASS  VII. —  Water  plays  an  important  part  in  the 
many  chemical  reactions  and  tissue  changes  continually 


FOOD  CLASSIFICATION  13 

going  on  in  the  body;  it  holds  the  various  salts  in  solu- 
tion; it  makes  up  the  principal  part  of  all  body  fluids 
and  secretions;  and,  as  a  circulatory  medium,  it  helps 
to  make  it  possible  for  the  body  to  regulate  its  own 
temperature. 

All  food  is  built  up  in  nature's  laboratory  by  a  proc- 
ess called  synthesis.  For  example,  take  the  apple,  which 
is  made  up  chiefly  of  fruit  sugar  and  cellulose,  with 
accompanying  vitamines,  salts,  and  water.  The  sugar 
and  cellulose,  both  belonging  to  the  carbohydrate  class, 
contain  the  chemical  elements  carbon,  hydrogen,  and 
oxygen. 

Nature's  Laboratory 

The  chlorophyll,  or  green  coloring  matter  of  the  plant, 
first  manufactures  starch,  obtaining  its  carbon  from  the 
ever-present  carbonic  acid  gas  or  carbon  dioxide  (CO,) 
of  the  air,  and  giving  back  to  the  air  the  oxygen.  Water 
(H20),  coming  up  through  the  roots  with  its  hydrogen 
and  oxygen,  supplies  to  the  chlorophyll  these  elements 
to  complete  the  process  of  starch  making.1 

From  some  of  this  starch,  cellulose  is  made,  and  later, 
as  the  apple  ripens,  the  remaining  starch  is  changed 
into  sugar. 

In  the  same  way  the  elements  necessary  for  the  vita- 
mines  and  salts  are  obtained  from  the  soil.  All  are 
combined  in  a  wonderful  way  until  we  have  as  a  result 
the  finished  product,  the  apple  ripened  and  tinted  by 
the  sun. 

Before  it  can  be  utilized  in  the  body,  however,  a  very 
different  process  goes  on.  From  the  time  the  apple  is 
seized  by  the  teeth  the  process  becomes  one  of  disinte- 
gration, or  analysis,  begun  by  the  mechanical  action  of 


irThe  chemical  formula  for  starch  is  (C6H10OB)n.  The  formation  of  starch  in 
the  plant  may  be  represented  by  the  chemical  equation :  6COa  (carbonic  acid  gas) 
-f-  5H2O  (water)  =  CeHioOs  (starch)  +  Oi2 (oxygen).  The  starch  remains  as  a  part 
of  the  plant  —  the  oxygen  returns  to  the  air. 


14  THE   HOME   DIETITIAN 

mastication.  It  is  continued  by  the  muscular  activity  of 
the  digestive  tract  until  the  food  becomes  a  thoroughly 
liquefied  mass. 

A  Twofold  Phase  of  Digestion 

But  these  physical  changes  are  not  sufficient.  That 
the  food  may  be  yet  more  completely  simplified  and  dis- 
solved, certain  juices  are  poured  out  along  the  digestive 
tract  which  break  up  the  food  molecules  into  still  more 
simple  forms,  that  the  next  important  step  may  take 
place  with  the  greatest  ease  and  completeness.  Thus, 
chemical  action,  in  addition  to  mechanical  action,  pre- 
pares the  food  for  the  process  of  absorption  into  the 
body  proper,  where  it  may  repair  and  build  the  tissues 
and  produce  the  necessary  heat  and  energy  for  the  effi- 
cient conduct  of  all  body  processes. 

In  this  digestive  process  all  starch  is  changed  to  sugar 
(see  footnote,  page  59),  all  complex  sugars  to  simple 
sugar  or  dextrose,  fats  are  emulsified,  and  proteins  are 
reduced  to  simpler  forms  called  proteoses,  peptones,  and 
amino  acids.  Many  of  these  processes  can  be  carried 
on  to  some  extent  outside  the  digestive  tract;  thus  we 
have  certain  predigested  foods,  such  as  dextrinized 
cereals,  in  which  the  starch  has  been  largely  changed 
to  dextrin  by  extreme  heat,  e.  g.,  oven  toast,  shredded 
wheat,  corn  flakes,  etc.  Likewise  fats  may  be  eaten  in 
an  already  emulsified  form,  as  in  nut  butter  and  cream. 
The  sugar  of  fruit  being  in  the  form  of  dextrose  and 
levulose  (see  top  of  page  59),  needs  practically  no 
digestion. 

Starch  digestion  begins  in  the  mouth  and  is  com- 
pleted, with  the  simplifying  of  the  complex  sugars,  in 
the  small  intestine.  The  solution  of  protein  and  its 
change  into  proteoses  and  peptones  begin  in  the  stomach 
and  are  completed,  with  its  final  reduction  to  amino 


POOD  CLASSIFICATION  15 

acids,  in  the  intestine.  The  preparation  of  fat  for  ab- 
sorption is  carried  on  entirely  in  the  intestines,  by  emul- 
sification  and  by  a  process  of  splitting  up  into  more 
simple  parts,  called  saponification  (soap  formation). 
(See  page  51.) 

A  Carburetor 

Thus  the  digestive  tract  becomes  a  great  preparation 
chamber,  a  carburetor,  as  it  were,  where  the  food  is 
transformed  into  a  simple  state  and  put  into  solution 
so  that  it  can  easily  be  taken  up  by  the  blood  and  thus 
carried  to,  and  properly  utilized  by,  the  body  cells. 

Strange  as  it  may  seem,  the  digestive  tract  must  be 
considered  physiologically  as  outside  the  body  proper. 
It  is  simply  a  tube  extending  through  the  body,  but  not 
connected  with  it  except  by  an  absorbing  medium,  the 
mucous  membrane.  It  is  continuous  with  the  outside 
world  from  which  it  receives  food  substances  and  into 
which  are  discharged  those  parts  which  cannot  be  pre- 
pared for  reception  by  the  blood  and  tissues.  The  lining 
membrane  of  the  digestive  tract  tries  carefully  to  guard 
the  body  cavity  against  intrusion  into  it  of  substances 
which  are  undesirable  or  might  do  harm;  and,  normally, 
after  careful  preparation,  only  that  part  of  the  food 
which  can  serve  as  material  to  replace  worn-out  tissue 
or  as  fuel  to  produce  heat  and  energy,  is  passed  on  into 
the  blood. 

A  Sentinel 

However,  as  the  result  of  putrefactive  processes  going 
on  in  the  intestine,  certain  poisons  are  also  carried 
through  the  mucous  membrane.  These  would  quickly 
prove  fatal  were  it  not  for  the  faithful  liver  which 
stands  as  a  sentinel  to  prevent  these  toxic  materials 
from  gaining  entrance  into  the  general  circulation.  The 
liquefied  and  simplified  food  passing  through  the  mucous 


16  THE   HOME   DIETITIAN 

membrane  of  the  small  intestine,  enters  many  tiny  blood 
vessels,  or  capillaries,  which  carry  it  to  the  portal  vein, 
through  which  it  is  conveyed  to  the  liver.  Here  the 
poisonous  substances  are  filtered  out  to  be  transformed 
by  the  liver  cells  into  harmless  materials,  and  the  puri- 
fied food  passes  on  into  the  general  blood  stream.2  The 
liver  also  acts  as  a  great  storehouse  for  sugar,  this  part 
of  the  food  entering  the  system  according  to  body 
demands. 

If,  as  a  result  of  dietetic  errors,  intestinal  putrefac- 
tion is  excessive,  the  amount  of  toxic  material  taken  up 
by  the  great  absorbing  surface  of  the  small  intestine 
may  be  so  great  that  even  the  ever-vigilant  liver  is  un- 
able to  filter  out  these  poisons  and  to  prevent  their  en- 
trance into  the  blood,  where  they  are  carried  through- 
out the  body,  causing  various  kinds  and  degrees  of  ill 
health. 

The  Cycle  of  Life 

Even  though  the  food  has  been  received  by  the  blood, 
its  analysis  is  not  yet  complete,  but  is  carried  on  still 
further  in  connection  with  a  form  of  oxidation  or  com- 
bustion. During  this  process  the  nutritive  substances 
are  utilized  by  the  tissues,  and  finally,  being  reduced  to 
a  simple  state,  they  are  eliminated  as  waste  by  the 
lungs,  skin,  and  kidneys.  Now  they  can  again  be  taken 
up  by  the  plant  and  combined  into  materials  which  may 
be  used  as  food  by  animals  and  man.  Thus  the  cycle 
of  life  goes  on,  nothing  ever  lost,  each  chemical  element 
being  used  again  and  again. 

Just  how  these  final  steps  in  the  process  of  food 
analysis  are  carried  on  in  the  tissues,  we  will  consider 
further  in  the  next  chapter,  in  connection  with  the 
study  of  metabolism. 

2  The  digested  fat,  called  chyle,  does  not  pass  with  the  other  food  to  the  liver, 
but  is  absorbed  directly  into  the  lymphatic  system. 


CHAPTER  II 
THE  BODY  AS  A  STOVE;  METABOLISM 

IT  is  important  that  we  study  more  fully  the  oxida- 
tion processes  through  which  the  food  passes  after  it  is 
absorbed  by  the  wall  of  the  digestive  tract.  This  final 
process  of  food  reduction  is  included  in  the  subject, 
metabolism. 

Cell  Building 

Food  does  not  arrive  at  its  ultimate  destination  until 
it  reaches  the  individual  cell.  Here  the  nitrogenous  por- 
tion is  built  up  into  the  cell  itself;  the  carbohydrate  and 
fat  afford  energy  for  cell  activity.  Thus  new  cells  are 
made,  old  cells  are  renewed,  this  process  of  cell  building 
and  repair  being  that  part  of  metabolism  known  as 
anabolism. 

In  connection  with  the  activity  and  life  processes  of 
the  cell  which  are  made  possible  by  the  energy  resulting 
from  the  oxidation,  or  combustion,  of  the  food  taken  up 
by  the  cell,  waste  material,  made  up  of  broken-down 
cells  and  the  products  of  combustion,  is  produced  which 
is  carried  by  the  blood  stream  to  its  proper  outlet.  This 
process  of  tearing  down  and  waste  formation  is  that 
part  of  metabolism  called  katabolism. 

The  Fuel 

In  connection  with  these  changes  of  waste  and  repair, 
or  metabolism,  the  body  may  be  compared  to  a  stove. 
The  food  is  the  fuel,  which  is  as  truly  burned  in  the 
tissues  as  is  gas,  wood,  or  coal  burned  in  a  furnace. 
This  slow  combustion  is  a  true  oxidation  process,  and 
oxygen  is  as  necessary  for  the  body  fires  as  it  is  for  the 

2  17 


18  THE    HOME   DIETITIAN 

more  rapid  oxidation  which  goes  on  in  the  ordinary 
stove.  The  lungs  serve  as  both  drafts  and  flue,  and  a 
perfect  circulation  of  the  oxygen  received  is  made  pos- 
sible by  the  circulation  of  the  blood.  The  kidneys  are 
the  grates  through  which  the  ash  is  eliminated. 

The  oxidation  of  carbohydrate  and  fat  results  in  the 
production  of  heat,  or  other  forms  of  energy,  the 
end  products  being  carbonic  acid  gas  (C02)  and  water 
(H20).  These  are  eliminated  through  the  lungs,  the 
skin,  and  the  kidneys  as  simple  gas  and  water.  There 
is  no  ash,  just  as  there  is  none  from  the  burning  of 
gas  in  a  gas  heater.  Starches,  sugars,  and  fats  are  sim- 
ply fuel  foods  necessary  for  heat  and  energy,  but  have 
nothing  to  do  with  tissue  repair. 

Tissue  Building 

Tissue  repair  is  the  additional  work  of  protein.  Pro- 
tein contains  nitrogen  in  addition  to  its  carbon,  hydro- 
gen, and  oxygen.  The  nitrogen  is  used  in  the  work  of 
cell  building  and  cell  repair.  It  is  the  iron  of  the  stove 
and  while  not  needed  in  such  large  amounts,  is  of  vital 
importance ;  for  if  the  body  stove  is  not  kept  in  constant 
repair,  it  will  soon  enter  a  state  of  dissolution.  As  pro- 
tein contains  carbon,  hydrogen,  and  oxygen,  some  heat 
and  energy  results  from  the  oxidation  of  this  part  of 
the  protein  molecule,  which  is  about  58  per  cent  of  the 
whole.  Carbon  dioxide  and  water  are  in  this  way  given 
off,  but  the  distinctive  work  of  this  food  element  has 
to  do  with  its  nitrogenous  portion  (see  page  85). 

Building  Stones 

The  protein  molecule  is  very  complex,  and  varies 
within  wide  limits.  Its  nitrogen  is  always  combined 
with  carbon,  hydrogen,  and  oxygen,  but  in  many  dif- 
ferent ways  to  form  different  kinds  of  protein.  The 


THE   BODY   AS   A   STOVE  19 

arrangement  of  the  nitrogenous  combinations  in  the 
food  proteins  is  different  from  that  of  the  tissue  pro- 
teins, so  after  the  breaking-down  process  that  the  food 
undergoes  in  connection  with  digestion,  the  nitrogenous 
links  are  put  together  again  in  the  various  necessary 
combinations  to  form  the  many  kinds  of  tissue.  A  com- 
plete protein  contains  seventeen  or  eighteen  of  these 
nitrogenous  units,  which  are  called  amino  acids  and 
have  been  likened  to  building  stones.  (See  pages  43 
and  76.)  Rearrangement  of  these  amino  acids  makes 
possible  the  formation  of  the  tissues  that  go  to  make  up 
the  body.  (An  amino  acid  contains  the  radical  NH2.) 

The  Body  Grates 

As  the  result  of  cellular  activity  and  oxidation,  a  defi- 
nite solid  ash  is  formed,  in  which  form  the  nitrogen  is 
eliminated  through  the  body  grates,  or  kidneys,  in  so- 
lution in  the  urine.  Urea,  uric  acid,  purines,  creatine, 
and  other  allied  bodies  make  up  this  solid  ash.  The 
most  completely  reduced  form  is  urea,  which  is  the 
most  important  end  product  of  protein  metabolism,  and 
the  form  in  which  the  greater  part  of  the  nitrogen  is 
eliminated.  There  is  normally,  however,  a  certain  small 
part  of  the  ash  not  so  completely  metabolized,  which 
must  be  eliminated  as  uric  acid  and  purines,  but  these 
in  excess  soon  become  abnormal. 

An  Expensive  Fuel 

Any  protein  not  needed  for  tissue  building  may  be 
used  by  the  body  to  produce  heat  and  energy,  the  nitro- 
gen being  split  off  and  eliminated  in  the  usual  way. 
But  this  would  be  a  waste  of  nitrogen,  and  a  needless 
task  imposed  on  the  excretory  organs.  It  could  not, 
therefore,  be  considered  economy  if  it  were  possible  to 
obtain  this  energy  from  the  strictly  fuel  foods  that  leave 


20  THE    HOME   DIETITIAN 

no  nitrogen  for  elimination.  This  use  of  nitrogen  would 
be  analogous  to  burning  iron  in  a  furnace.  While  it 
might  be  possible,  it  would  hardly,  under  ordinary  cir- 
cumstances, be  considered  wise  or  economical. 

Clinkers  and  Soot 

Thus  as  the  result  of  oxidation  and  reduction  proc- 
esses, the  food,  whether  carbohydrate,  fat,  or  protein,  is 
reduced  to  a  simple  state  which  makes  complete  elimina- 
tion from  the  body  possible.  If  for  any  reason  oxida- 
tion is  incomplete,  the  process  of  elimination  is  greatly 
hindered;  the  ash  is  not  finely  divided,  but  is  full  of 
clinkers,  the  grate  becomes  clogged,  and  waste  products 
are  retained,  which  further  clog  the  body  stove  and 
hinder  the  normal  oxidation  processes.  Incomplete  oxi- 
dation of  carbohydrates  and  fats  may  also  clog  the  tis- 
sues in  much  the  same  way  as  soot  clogs  a  gas  burner 
when,  as  the  result  of  incomplete  oxidation,  it  gives  a 
yellow  flame  with  its  unoxidized  carbon,  instead  of  a 
blue  flame,  in  which  all  carbon  is  thoroughly  burned. 
(See  page  28.) 

For  this  reason  it  is  important  that  the  body  fuel, 
while  sufficient,  be  not  excessive,  that  the  drafts  be 
kept  well  open,  and  that  there  be  a  free  circulation  of 
oxygen.  Then  the  fuel  will  be  thoroughly  burned,  the 
ash  finely  divided,  and  elimination  will  be  complete. 
There  will  be  no  soot,  clinkers  will  not  clog  up  the  grate 
or  back  up  into  the  stove,  and  the  stove  will  not  smoke. 
The  vital  fires  will  burn  brightly,  and  all  organic  func- 
tions will  be  carried  on  in  the  normal  way  that  makes 
for  health  and  strength. 


CHAPTER  III 

DEFECTIVE  FOOD  ANALYSIS;  AUTO- 
INTOXICATION 

WE  have  seen  that  the  passage  of  the  food  through 
the  body  means  a  gradual  reduction  from  a  complex  to 
a  simple  state.  That  this  reduction  should  go  on  in  a 
normal  way  and  at  a  normal  rate,  is  all-important. 
Certain  conditions,  chiefly  dietetic  errors,  result  in  great 
interference  with  these  processes,  both  while  the  food  is 
still  in  the  digestive  tract  and  after  absorption,  when  it 
has  been  taken  up  by  the  blood  and  tissues, —  the  first, 
slow  and  imperfect  digestion;  the  second,  faulty  and  in- 
complete metabolism. 

A  Serious  Defect 

The  first  and  most  common  defect  in  food  analysis  is 
in  the  process  of  mastication.  Carelessness  in  regard  to 
this  most  important  initial  process  lies  at  the  foundation 
of  much  of  the  imperfect  digestion  in  the  lower  alimen- 
tary tract. 

As  the  result  of  imperfect  disintegration  in  the  mouth, 
food  substances  are  hurried  into  the  stomach  faster  and 
in  larger  amounts  than  they  can  properly  be  received 
and  cared  for.  Food  received  by  the  stomach  in  nor- 
mal, well-masticated  portions,  already  in  a  semiliquid 
state,  begins  at  once  to  leave  the  stomach,  the  amount 
taken  in  continually  bearing  such  a  relation  to  that  pass- 
ing out  that  at  no  time  is  the  organ  overdistended  and 
thus  handicapped  in  its  muscular  movement.1 


1  X-ray  study  has  shown  that  the  liquid  portion  of  the  food  begins  at  once  to 
leave  the  stomach,  the  more  solid  portions  remaining  for  further  digestion.  As  the 
acid  contents  of  the  stomach  rush  through  the  pylorus  (the  outlet  of  the  stomach) 
into  the  first  part  of  the  small  intestine,  or  duodenum,  the  pylorus  closes,  the  bile 

21 


22  THE    HOME   DIETITIAN 

But  the  rapid  introduction  into  the  stomach  of  im- 
properly prepared  material  at  once  tends  to  overwhelm 
the  organ,  and  would,  could  it  be  seen,  produce  as  un- 
sightly a  spectacle  as  crowding  the  mouth  so  full  of 
food  that  mastication  is  made  awkward  and  almost  im- 
possible. This  food,  not  having  been  properly  reduced 
before  swallowing,  requires  an  excessive  amount  of 
churning  by  the  stomach  wall,  which  is  already  handi- 
capped by  overdistention. 

Advantage  of  Slow  Eating 

Incomplete  mastication  means  hurried  eating.  Hur- 
ried eating  leads  to  overeating,  because  the  introduction 
of  food  has  been  so  rapid  that  the  nerve  impulses  have 
not  had  time  to  return  with  their  message,  "  Enough ;  " 
and  thus  by  the  time  the  sensation  of  hunger  has  dis- 
appeared, an  excess  of  food  has  been  taken.  Every  one 
knows  how,  if  called  away  from  a  hurried  meal,  appe- 
tite perhaps  still  keen,  he  may  return  later,  only  to  find 
himself  satisfied  with  the  food  already  taken.  The 
nerve  impulses  of  satiety  take  a  little  time  to  report, 
hence  the  advantage  of  slow  eating.  If  one  must  eat 
hurriedly,  his  only  safety  lies  in  eating  within  safe 
limits  as  to  the  amount,  and  stopping  his  meal  while 
yet  the  appetite  may  call  for  more. 

Indigestible  food  substances,  wrong  combinations,  eat- 
ing at  too  frequent  intervals,  all  play  their  part  in  caus- 
ing slow  and  difficult  digestion,  and  thus  hindering  the 
normal  passage  of  the  food  through  the  alimentary 
tract. 

and  the  pancreatic  juice  flow  through  a  common  opening  into  the  duodenum, 
neutralizing  by  their  alkalinity  the  acidity  of  the  food  material  from  the  stomach. 
As  the  contents  of  the  duodenum  become  neutral,  or  alkaline,  the  pylorus  relaxes, 
and  more  of  the  gradually  liquefying  food,  or  chyme,  passes  out  of  the  stomach. 
Again  the  reflex  effect  of  the  acid  fluid  on  the  duodenal  mucous  membrane  causes 
a  contraction  of  the  pyloric  sphincter,  and  the  stomach  outlet  is  closed,  and  the 
same  alternating  process  is  continued  until  stomach  digestion  is  complete  and  the 
organ  is  at  rest.  The  length  of  time  required  depends  upon  the  amount,  kinds, 
and  combination  of  foods  taken  into  the  stomach,  and  varies  normally  from  two 
to  six  hours. 


DEFECTIVE   FOOD   ANALYSIS  23 

Three  Results  of  Delay 

Stagnation  in  the  stomach  or  intestine,  whatever  the 
cause,  means  one  or  all  of  three  abnormal  processes. 
Food  must  be  properly  digested  and  absorbed,  or  carbo- 
hydrates will  ferment,  protein  will  putrefy,  fats  will 
become  rancid.  These  processes  take  place  in  the  diges- 
tive canal  as  quickly  as  outside  it,  and  often  sooner,  be- 
cause the  conditions  are  ideal  for  germ  growth. 

In  the  stomach,  because  of  the  presence  of  the  germi- 
cidal  hydrochloric  acid,  germ  activity  is  hindered  and 
under  normal  conditions  made  impossible.  But  under 
the  conditions  mentioned  above,  fermentation  often 
takes  place,  resulting  in  "  sour  stomach,"  gas  formation, 
and  a  general  bad  state  of  affairs. 

Germs  at  Work 

In  the  intestine,  the  food  having  been  longer  on  the 
way  and  the  secretions  being  alkaline  instead  of  acid, 
germ  activity  goes  on  to  a  great  extent.  Under  normal 
conditions  this  may  even  assist  in  the  dissolution  of  the 
food ;  but  very  quickly,  under  conditions  of  slow  digestion 
and  retention,  food  decomposition  becomes  abnormal, 
fermentation  and  putrefaction  are  set  up,  resulting  in 
the  formation  of  gases  and  irritating  substances  that 
greatly  interfere  with  peristalsis  and  with  the  comple- 
tion of  digestion.  The  amino  acids,  instead  of  being 
allowed  to  pass  unhindered  through  the  mucous  mem- 
brane into  the  blood,  are  broken  down  by  the  germs  into 
decomposition  products.  Poisons  are  formed  which,  be- 
ing absorbed,  often  overwhelm  the  liver  (see  page  16), 
get  by  into  the  blood  stream,  and  slowly  but  surely  in- 
toxicate the  individual. 

Self-Poisoning 

As  the  result  of  carbohydrate  fermentation,  alcohol 
and  kindred  products  may  be  formed,  the  absorption  of 


24  THE    HOME   DIETITIAN 

which  may  produce  symptoms  of  chronic  alcoholism  in 
the  total  abstainer.  The  absorption  of  the  products  of 
protein  putrefaction,  becoming  excessive  and  acute, 
spells  "  bilious  attacks  "  or  perhaps  "  ptomaine  poison- 
ing/' but  oftener  in  a  chronic  way  these  poisons  grad- 
ually do  their  work,  causing  abnormal  fatigue,  lowered 
nerve  tone,  irritable  nerves,  headaches,  sallow  skin,  di- 
minished vitality,  and  functional  disturbances  of  any  or 
all  of  the  organs. 

Thus  in  this  great  preparation  chamber  there  may  be 
prepared  for  absorption,  poisons  as  well  as  food.  The 
food  itself  being  incompletely  digested,  much  of  it  may 
not  be  absorbed,  and  so  may  never  reach  its  destination. 
The  cells,  instead  of  receiving  their  needed  nourishment, 
are  handicapped  by  poisons,  and  their  activity  is  en- 
feebled. This  condition  of  poisoning  from  one's  own 
digestive  tract  is  known  as  "  auto-intoxication,"  or  self- 
poisoning,  and  is  widespread,  lying  at  the  foundation  of 
many  of  the  ailments  and  diseases  that  beset  the  civ- 
ilized race. 

A  Reckoning  Time 

With  those  who  are  naturally  robust  it  may  seem  that 
the  limit  of  work  imposed  upon  the  stomach  and  intes- 
tine need  only  be  determined  by  the  appetite  and  in- 
clination of  the  individual.  But  be  the  digestive  organs 
ever  so  strong,  with  the  ingestion  of  incompletely  mas- 
ticated food  in  unlimited  kind,  variety,  and  amount, 
perhaps  improperly  prepared  or  in  combination  with 
substances  difficult  of  digestion,  there  will  come  a  time 
when  these  faithful  organs  will  be  unable  to  do  the 
work  given  them  to  do,  even  though  the  amount  of 
work  be  decreased  to  normal  limits.  And  often  long 
before  symptoms  directly  referable  to  the  digestive  tract 
manifest  themselves,  the  amount  of  putrefaction  may 


DEFECTIVE    FOOD   ANALYSIS  25 

have  reached  the  stage  where  the  vitality  is  greatly  low- 
ered, signs  of  toxemia  appear,  and  gradually  but  surely 
the  health  and  efficiency  of  the  individual  is  under- 
mined. 

There  are  many  who,  having  a  smaller  amount  of  in- 
herent strength  in  the  digestive  organs,  feel  sooner  the 
results  of  the  conventional  careless  habits  of  eating. 
Not  realizing  the  cause  of  their  earlier  symptoms,  they 
continue  in  their  dietetic  mistakes  until  a  radical  pro- 
gram which  admits  to  the  alimentary  canal  only  the 
simplest  and  most  easily  digested  foods,  is  necessary  to 
give  the  organs  of  alimentation  an  opportunity  to  catch 
up,  as  it  were,  and  to  lay  in  a  store  of  reserve  strength 
that  they  may,  perchance  at  some  future  time,  be  able 
to  carry  on  a  normal  amount  of  work. 

A  Type 

This  type  of  person  is  sometimes  spoken  of  as  the 
auto-intoxication  type,  and  he  is  found  in  all  stages  and 
in  all  grades.  Under  this  head  comes  the  one  who  eats 
but  grows  thinner,  and  wonders  why;  the  one  who  suf- 
fers from  the  occasional  bilious  attack  and  certain  type 
of  sick  headache;  the  nervously  exhausted  person  with 
aches  too  numerous  to  mention  and  symptoms  as  varied 
as  temperament  and  susceptibility  may  differ;  the  dys- 
peptic, sallow,  thin,  despondent,  suffering  from  indiges- 
tion, gastric  distress,  constipation,  and  "gas,"  the  di- 
gestive organs,  unequal  to  their  task,  accomplishing  the 
little  they  do  by  much  coaxing,  the  tenderest  of  care, 
and  artificial  aid. 

Anemia 

The  cause  of  anemia  and  serious  organic  disorders  of 
the  nervous  system  is  coming  more  and  more  to  be  con- 
sidered referable  to  excessive  putrefaction  in  the  in- 
testine, with  slow  absorption  of  poisons. 


26  THE    HOME    DIETITIAN 

Thus  we  have  a  picture  of  some  of  the  various  con- 
ditions often  resulting  when  the  first  steps  in  body  food 
analysis  or  reduction  are  not  carried  on  properly.  No 
one  can  estimate  the  reserve  strength  of  his  digestive 
organs.  Often  the  one  who  early  has  evidence  of  a 
weak  digestion,  is  fortunate  because  he  is  of  necessity 
led  to  form  careful  dietetic  habits.  And  therefore  it 
were  well  could  all  adopt  a  sensible,  sane  plan  of  eating, 
following  natural  law,  eating  for  strength  and  not  for 
drunkenness,  wisely  selecting  and  preparing  their  food, 
and  partaking  of  it  in  such  a  way  as  to  assist  rather 
than  hinder  nature  in  her  efforts  to  utilize  it  to  the  best 
advantage. 


"  Life  is  shortened  by  death  and  narrowed 
by  invalidity." —  Fisher. 

"  To  keep  the  body  in  a  healthy  condition,  to 
develop  its  strength,  that  every  part  of  the 
living  machinery  may  act  harmoniously,  should 
be  the  first  study  of  our  lives." —  White. 


CHAPTER  IV 

DEFECTIVE    FOOD    ANALYSIS    (Continued); 
SUBOXIDATION 

Results  More   Remote 

As  has  already  been  suggested,  there  are  those  who 
suffer  little,  if  any,  from  digestive  disturbance,  because 
they  are  endowed  by  nature  with  great  vitality  and 
organic  strength. 

They  can  "  digest  anything,"  can  eat  at  any  time, 
anything  their  palate  calls  for,  and  never  suffer  the  dis- 
comforts of  indigestion.  One's  first  thought  might  be, 
How  fortunate  are  these!  but  that  is  not  entirely  true 
of  them ;  for  their  carelessness  and  ignorance  in  connec- 
tion with  alimentation  will  lead  to  a  condition  of  ill 
health  more  remote  perhaps,  but  as  truly  the  result  of 
dietetic  errors,  as  are  those  of  the  previous  class,  and 
often  these  results  prove  more  disastrous  in  the  end. 

Another  Type 

These  diseases  come  under  the  head  of  metabolic  dis- 
orders, and,  in  the  light  of  our  comparison  of  the  body 
to  a  stove,  we  will  speak  of  them  as  conditions  due  to 
suboxidation  and  of  the  individual  suffering  from 
them  as  belonging  to  the  suboxidation  type.  In  these 
persons  oxidation  is  imperfect,  elimination  of  cell  waste 
is  incomplete,  the  tissues  become  clogged  with  sub- 
stances which  should  be  eliminated,  the  grates,  or  kid- 
neys, do  their  work  incompletely,  and  "  the  stove 
smokes."  The  "  fires  are  banked." 

As  has  already  been  made  plain  in  a  previous  chap- 
ter, protein  metabolism  results  in  the  formation  of  a 

27 


28  THE    HOME    DIETITIAN 

solid  ash  which  is  in  the  form  of  urea,  uric  acid,1  pu- 
rine  bodies,  creatine,  and  certain  other  related  sub- 
stances. The  most  important  of  these  is  urea,  in  which 
form  most  of  the  nitrogen  is  eliminated. 

Rheumatism 

In  order  for  this  ash  to  be  properly  eliminated  it  must 
be  finely  divided  by  a  process  of  oxidation  and  analysis. 
Imperfect  metabolism  is  always  associated  with  sub- 
oxidation,  and  the  result  is  an  excess  of  an  incompletely 
oxidized  protein  ash,  which  backs  up  in  the  blood  stream 
as  "  clinkers."  These  accumulate  in  the  joints,  produc- 
ing rheumatism,  so  called,  and  in  the  muscles  they  are 
the  cause  of  lumbago  and  myalgia;  along  the  nerve 
sheaths  their  irritating  presence  may  produce  neuritis; 
accumulating  in  the  blood  vessel  walls,  they  cause  the 
arteries  to  lose  their  supple,  elastic  quality  and  to  become 
hard,  stiff,  and  brittle,  which  in  the  end  means  high  blood 
pressure,  an  overworked  heart,  and  often  apoplexy,  an- 
gina pectoris,  and  heart  failure.  The  kidneys  in  their 
effort  to  eliminate  an  excess  of  waste,  and  that  in  an  im- 
perfectly prepared  form,  are  overworked,  and  Bright's 
disease  may  be  the  result. 

Conditions  of  suboxidation  are  never  limited  to  pro- 
tein metabolism  alone,  but  there  is  ever  an  associated 
suboxidation  of  carbohydrates  and  fats  ;  in  fact,  it  seems, 
often,  to  be  the  imperfect  metabolism  of  an  excess  of 
energy  foods  that  is  the  causative  factor  in  the  produc- 
tion of  deficient  protein  oxidation.  (See  page  20.)  The 
body  stove  being  clogged  with  the  products  of  incomplete 


1  Uric  acid  (CaHiN^s)  and  the  purine  bodies,  as  xanthine,  hypoxanthine,  etc., 
are  very  closely  related  both  chemically  and  physiologically  to  each  other  and  to 
the  caffeine  (CgHjo^Oo)  of  tea  and  coffee  and  the  theobromine  (C7HsN4O2)  of 
cocoa.  Uric  acid  and  the  purines  result  principally  from  the  metabolism  of  the 
nucleoproteins.  Nucleoprotein  is  abundant  in  meat,  especially  _  in  glandular  tis- 
sue, as  liver,  sweetbreads,  etc.  A  purine-free  diet  is  one  in  which  meats  and  tea 
and  coffee  are  excluded.  Purines  are  found  also  to  an  extent  in  some  other  foods, 
as,  e.  g.,  eggs  and  legumes. 


DEFECTIVE   FOOD   ANALYSIS  29 

carbohydrate  and  fat  metabolism,  cannot  carry  on  the 
active  oxidation  processes  necessary  to  burn  up  the  pro- 
tein wastes,  whether  or  not  excessive. 

A  Cause  of  Obesity 

Carbohydrate,  containing  the  same  chemical  elements 
as  fat,  is  readily  changed  over  in  the  tissues  into  fat,  and 
these  two  food  classes,  instead  of  being  used  up  in  energy 
production,  may  be  stored  excessively  as  adipose  tissue, 
and  this  often  at  the  expense  of  muscle. 

So  in  this  type  we  have  the  obese,  rheumatic,  gouty 
individual,  short  of  breath,  for  whom  exercise  becomes 
difficult,  thus  adding  another  factor  in  the  causation  of 
the  ever-increasing  condition  of  suboxidation. 

Ills  Due  to  Wrong  Habits 

But  this  suboxidation  type  of  person  has  a  good  di- 
gestion, with  its  accompanying  good  appetite,  is  fond  of 
rich,  concentrated  food,  and,  unaware  that  his  ills  are 
directly  due  to  his  wrong  habits  of  eating,  he  goes  blindly 
on  overloading  his  body  furnace  with  fuel  that  it  cannot 
oxidize,  or  eliminate,  and  that  only  serves  to  increase  the 
clinkers  that  hinder  the  burning  of  the  vital  fires. 

Often  it  is  not  the  bulk  of  the  food  intake,  but  its  con- 
centration in  fats  and  sweets,  that  determines  its  excess, 
and  as  we  study  further  the  question  of  food  values,  it 
will  be  seen  how  easily  food  can  be  taken  in  excess  of 
body  needs. 

While  some  may  suffer  from  underfeeding,  yet  in  con- 
ditions of  prosperity  the  diseases  of  the  race  due  to  im- 
proper alimentation  are  the  result,  almost  entirely,  of  an 
excess  of  food,  rather  than  the  result  of  a  deficient 
amount,  a  condition  of  underfeeding  sometimes  following 
on  as  the  result  of  conditions  caused  primarily  by  a  too- 
abundant  food  intake. 


30  THE    HOME   DIETITIAN 

Important   Conditions 

Again  we  will  enumerate  the  conditions  necessary  for 
perfect  oxidation  and  thereby  make  evident  the  remedy: 

1.  Proper  kind  and  amount  of  fuel  —  a  properly  bal- 
anced food  supply  in  direct  proportion  to  body  needs. 

2.  Open    drafts:     (a)    an    ample    supply    of    oxygen 
through  the  lungs;   (b)   the  carrying  of  the  oxygen  to 
every  cell  by  a  free  circulation  of  the  blood,  made  pos- 
sible only  by  exercise. 

3.  A  finely  divided  ash,  free  from  clinkers,  so  that 
thorough  elimination  may  be  possible.     This  may  neces- 
sitate a  limited  intake  of  fuel  for  a  time,  giving  the  body 
a  chance  to  burn  up  what  is  already  on  hand  in  excess. 

Exercise 

The  subject  of  eating  cannot  be  separated  from  that 
of  the  oxygen  we  breathe  in,  and  the  exercise  we  are  able 
to  take.  An  ample  supply  of  oxygen  must  reach  the 
lungs,  but  oxygen  which  goes  no  farther  than  the  lungs 
does  the  tissues  no  good.  It  must  be  carried  throughout 
the  body  by  the  blood,  a  perfect  circulation  of  which  is 
possible  only  under  conditions  of  more  or  less  vigorous 
exercise.  The  freely  moving  blood  stream  carries  both 
fuel  and  oxygen  to  the  cells  and  thoroughly  cleanses  tis- 
sue, muscle,  and  organ  from  waste  matter,  carrying 
these  wastes  to  their  avenues  of  elimination. 

Often  the  person  suffering  from  suboxidation  reaches 
the  point  where,  because  of  obesity,  fatty  heart,  or  high 
blood  pressure,  exercise  is  impossible.  Under  these  con- 
ditions the  problem  of  increasing  the  circulation  and  the 
metabolic  processes  becomes  largely  one  of  diet  regula- 
tion, the  exercise,  of  necessity,  being  largely  passive,  as 
in  massage  and  manual  Swedish  movements. 

The  intelligent  treatment  of  obesity,  with  its  allied  con- 
ditions, by  diet  adjustment  upon  the  basis  of  measuring 


DEFECTIVE   FOOD   ANALYSIS  31 

the  fuel  supply  is  most  satisfactory,  the  treatment  of  no 
abnormal  condition  promising  more  sure  results.2 

Defective  food  analysis,  whether  in  the  digestive  tract 
or  in  the  tissues,  lessens  the  alkalinity  of  all  body  fluids, 
producing  a  more  nearly  acid  condition  of  the  blood. 
Acids  are  formed  as  the  result  of  fermentation  and  ab- 
normal food  decomposition  in  the  intestinal  tract,  and  as 
the  result  of  cell  waste  and  katabolism  in  the  tissues.3 
These  wastes,  not  being  properly  oxidized  and  eliminated, 
lessen  the  alkalinity  of  the  blood  because  of  the  excess  of 
acid  products.  (See  page  52.) 

While  all  of  these  conditions  do  not  come  to  one  indi- 
vidual, and  to  many  only  in  a  minor  degree,  yet  the  ever- 
increasing  occurrence  of  these  diseases  with,  because  of 
them,  the  lowered  life  expectancy  of  the  man  past  forty, 
bears  witness  to  the  fact  that  metabolic  disorders  are  be- 
coming more  prevalent  and  must  be  reckoned  with  in  the 
struggle  for  race  conservation. 

As  diseases  of  metabolism  are  so  common  and  most  of 
them  due  to  an  improper  food  supply,  the  understanding 
of  food  values,  as  to  both  quality  and  quantity,  becomes 
a  very  important  matter.  How  we  may  measure  our  food 
intake  easily,  but  scientifically,  and  make  this  knowledge 
of  practical  value,  we  shall  consider  in  our  next  chapter. 


2  To  those  who  desire  to  study  more  fully  the  dietetic  treatment  of  obesity,  we 
would  recommend  that  amusing  and  instructive  little  book  by  Dr.  Lulu  Hunt-Peters, 
"  Diet  and  Health  with  Key  to  the  Calories." 

3  There  is  a  difference  in  the  acidity  of  the  ash  resulting  from  the  metabolism 
of  various  foods,  e.  g.,   the  metabolism   of  meat  yields   an  acid   ash,   that  of   vege- 
tables an  alkaline  ash.     Most  fruits  are  base  forming,  thus  increasing  the  alkalinity 
of  the  blood   (see  Chapter  VIII),  while  cereals  furnish   in  their  metabolism  a  pre- 
ponderance of  acid. 


"  Our  bodies,  in  other  words,  should  be  such 
good  machines  that  their  running  will  cause  no 
creaking  or  jolting." —  Hare. 


CHAPTER  V 
THE  FOOD   UNIT,  OR  CALORIE 

How  Much  Fuel? 

OF  the  seven  food  classes,  three  are  oxidized  in  the  body 
and  may  be  measured  by  the  calorie,  or  heat  unit.  In 
this  way  we  may  as  easily  measure  our  body  intake  of 
fuel  as  can  the  manufacturer  who  estimates  the  amount 
of  coal  necessary  to  furnish  the  energy  required  to  run 
the  machinery  of  his  plant.  Every  ounce  of  protein,  fat, 
or  carbohydrate  taken  into  the  tissues  produces  a  definite 
amount  of  heat.  Heat  can  always  be  converted  into 
energy. 

The   Calorimeter 

The  instrument  used  in  measuring  the  heat  value  of 
food  is  called  a  calorimeter,  and  simply  described  is  this : 
A  double  chamber  —  in  the  inner  chamber  a  given  quan- 
tity of  food,  e.  g.,  an  ounce  of  sugar;  in  the  outer  cham- 
ber a  given  quantity  of  water  of  a  known  temperature. 
The  food  in  the  inner  chamber  is  ignited  by  an  electric 
spark.  When  the  burning  is  complete,  the  temperature 
of  the  water  in  the  outer  chamber  is  taken  and  the  in- 
crease in  temperature  shows  the  energy  or  caloric  value 
of  that  food. 

The  Calorie 

The  amount  of  heat  required  to  raise  the  temperature 
of  a  pound  of  water  4°  F.,  or  of  one  kilogram  of  water 
1°  C.,  is  a  calorie.  The  slow  combustion  of  an  ounce  of 
food  in  the  body  tissues  will  produce  the  same  amount 
of  heat  as  if  oxidized  rapidly  in  a  calorimeter. 

By  experiment  it  has  been  found  that  the  heat  value 
of  a  gram  of  pure  water-free  protein,  e.  g.,  the  casein 
32 


THE   FOOD   UNIT  33 

of  milk,  egg  albumen,  fiber  of  meat,  is  four  calories;  of 
a  gram  of  pure  carbohydrate,  as  starch  or  sugar,  four 
calories;  but  of  a  gram  of  fat,  more  than  two  times  as 
much,  or  nine  calories.1  An  ounce  equals  about  thirty 
grams;  therefore,  multiplying  the  above  figures  by 
thirty,  gives  the  number  of  calories  per  ounce. 

Different  foods  contain  varying  amounts  of  these  oxi- 
dizable  substances;  accordingly,  the  caloric  value  of 
foodstuffs  depends  upon  the  amount  of  protein,  fat,  or 
carbohydrate  they  contain;  e.  g.,  an  ordinary  slice  of 
bread  weighing  1J4  ounces,  or  38  grams,  contains  ap- 
proximately 4  grams  of  protein,  2  grams  of  fat,  and  16 
grams  of  carbohydrate,  the  16  grams  remaining  being 
water  and  cellulose. 

4  grams  of  protein  equals     16  calories 

2  grams  of  fat  equals     18  calories 

16  grams  of  carbohydrate  equals  .  .   64  calories 

Total     98  calories 

Or  approximately  100  calories. 

By  a  little  study,  one  may  very  easily  become  familiar 
with  the  approximate  values  of  common  foods  and  be 
able  to  arrive  at  some  conclusion  as  to  what  one's  daily 
ration  should  be,  both  as  to  its  amount  and  as  to  the 
proportion  of  food  elements.  Many  would  be  surprised 
to  find  how  far  short  their  diet  comes  of  the  ideal,  which, 
if  followed,  with  proper  habits  of  eating,  would  result  in 
the  maximum  of  health  and  strength. 

A  Practical  Application 

It  is  very  easy  to  remember  that  one  slice  of  bread 
contains  100  food  units,  one  egg  75,  a  glass  of  milk  150, 
an  average  potato  125,  a  tablespoonful  of  average  cream 
about  40,  a  serving  of  cooked  cereal  75  to  100  calories, 

1More  accurately — 1  gram  of  protein  equals  4.1  calories;  1  gram  of  carbohy- 
drates equals  4.1  calories  ;  and  1  gram  of  fat  equals  9.3  calories. 


34  THE    HOME   DIETITIAN 

an  ordinary  serving  of  green  and  leaf  vegetables  25  to 
50,  depending  upon  the  amount  of  fat  or  milk  added, 
average  serving  of  legumes  100  to  150  calories ;  also  that 
desserts  are  higher  in  food  value,  ranging  from  125 
calories  for  a  simple  custard  or  junket  to  350  for  one 
sixth  of  a  pie.  (See  table  of  food  values  in  the  Ap- 
pendix.) These  and  many  others  in  a  short  time  become 
very  familiar  to  the  housewife  interested  in  food  values. 

Food    Requirements 

The  amount  of  food  req'uired  by  an  individual  varies 
with  height,  age,  sex,  and  muscular  activity,  but  for  the 
average  person  2,000  calories  may  be  taken  as  a  working 
basis.  One  above  average  height  will  need  more  per- 
haps. Other  things  being  equal,  men  need  about  10  per 
cent  more  than  women.  If  engaged  in  active,  muscular 
labor,  the  requirements  may  be  2,500  to  3,000,  or  even 
more  in  the  case  of  a  farmer,  a  lumberman,  or  a  soldier. 
Those  of  sedentary  habits  often  do  better  on  less  than 
2,000,  or  even  as  low  as  1,500  to  1,800  calories.  This 
will  depend  upon  the  height,  temperament,  and  natural 
tissue  activity. 

An  obese  person  or  one  suffering  from  the  results  of 
imperfect  oxidation,  as  manifested  by  rheumatic  joints 
or  high  blood  pressure,  may  do  well  for  a  time  on  as 
low  as  from  1,000  to  1,200  food  units  daily,  with 
marked  relief  from  symptoms ;  and,  if  obese,  a  reduction 
of  from  one  to  four  pounds  a  week. 

How   Much   Protein? 

The  amount  of  protein  needed  does  not  vary  within 
such  wide  limits.  The  amount  remains  more  nearly 
constant,  and  should  yield  from  200  to  300  calories  in 
twenty-four  hours,  even  though  the  total  ration  be  low. 
On  the  average  ration  this  would  be  about  10  per  cent 


THE    FOOD    UNIT  35 

of  the  entire  daily  food  intake,  but  if  one  does  well  on 
the  low  ration  as  suggested  above,  the  protein  must  not 
be  reduced  proportionately,  but  should  be  kept  near  the 
normal  of  at  least  200  calories;  for  the  body,  not  being 
able  to  store  this  repair  material  in  excess,  must  have  it 
supplied  to  it  in  regular  daily  amounts. 

How  Much  Fat? 

The  fat  intake  should  yield  from  400  to  800  food  units 
a  day.2  A  study  of  food  values  soon  makes  it  very  evident 
that  the  average  individual  takes  much  more  than  this 
amount  in  his  daily  food  ration.  The  remainder  of  the 
total  calories  is  made  up  of  carbohydrate.  Fat  and  car- 
bohydrate can  to  an  extent  be  substituted  one  for  the 
other,  but  an  excess  of  fat  should  be  avoided.  This  we 
will  discuss  in  a  later  chapter. 

Food  Values 

Those  who  may  want  to  familiarize  themselves  more 
thoroughly  with  food  values,  we  would  refer  to  tables 
of  caloric  food  values  Nos.  I  and  II,  in  the  Appen- 
dix. Table  I  gives  the  approximate  energy  value  of  the 
cooked  and  ready-to-serve  foods  commonly  used.  An 
effort  has  been  made  to  arrange  them  so  that  the  house- 
wife may  be  able  to  see  at  a  glance  the  food  value  of 
the  average  helping  of  the  various  dishes  appearing  upon 
her  table,  and  the  proportion  of  protein,  fat,  and  carbo- 
hydrate contained  in  each.  These  percentages  are  of 
the  total  number  of  food  units  and  not  of  the  weight. 
Fractions  and  decimals  have  been  disregarded  in  most 
cases. 

Because  of  the  variation  in  recipes  for  the  same  dish, 
many  of  the  figures  in  the  tables  can  only  be  approxi- 


2  This  need  not  be  in  the  form  of  free  fat.    Many  foods  contain  a  high  proportion 
of  fat,  as  milk,  eggs,  olives,  nuts. 


36 


THE    HOME   DIETITIAN 


mate,  but  given  the  ingredients,  the  value  of  any  dish 
may  be  estimated  with  a  fair  degree  of  accuracy  by  the 
use  of  Table  II.  (See  page  339.)  This  table  gives  the 
value  of  staple  foodstuffs,  both  raw  and  cooked,  used  in 
cooking  and. in  the  making  up  of  various  recipes.  From 
this  table  the  housewife  may  easily  estimate  the  calories 
contained  in  a  serving  of  any  dish  she  may  prepare. 
Take  for  example  the  following  recipe: 

Spinach   Soup 


II 

| 

,.gS 

8$1 

3! 

g-3! 

Is'oS 

&!?.•§ 

•5-3 

fcW 

fro 

OJ30 

HO 

Spinach   1  quart  (4  oz  )   

9 

65 

12 

27  5 

See  p  344 

Onion    1  thin  slice 

5 

5 

4 

5 

See  p  343 

Stale  bread    2  slices    

26 

12 

162 

200 

See  p  340 

Skim  milk.  1  auart    , 

128 

24 

192 

344 

See  D.  342 

For  six  servings  divide  by  6 1 163.5 1   43    |   370  1 576.5 1 

|   27    |     7    |     62   j   96    | 

Therefore,  each  serving  of  soup  will  contain  96  calories, 
of  which  27  are  protein,  7  are  fat,  and  62  are  carbohy- 
drate. 

Put  the  spinach  and  onion  through  the  meat  chopper, 
following  with  the  bread  to  prevent  waste.  Put  into  a 
double  boiler  with  the  milk,  and  cook  until  tender.  This 
is  a  relatively  high  protein  dish,  more  than  one  fourth 
of  the  calories  being  protein,  and  shows  a  good  use  for 
skim  milk  and  stale  bread.  Try  it. 

These  tables  are  simply  for  reference,  and  in  no  way 
need  add  to  the  housewife's  burdens.  But  those  inter- 
ested will  find  them  very  simple  and  easy  to  use,  and  a 
great  help  when  it  is  desired  "  to  take  inventory,"  as  it 
were,  of  the  food  situation  in  any  home,  or  in  any  in- 
dividual case.  In  a  very  short  time  the  housewife  may 
find  that  she  has  a  mental  picture  of  foods,  as  to  their 
energy  value,  far  different  than  she  ever  had  before; 


THE    FOOD    UNIT  37 

and  she  can  at  any  time  she  wishes  check  up  as  to  the 
amount  of  food  any  member  of  her  family  may  be  tak- 
ing. More  important  even  than  to  determine  the  total 
amount  is  the  ease  with  which  she  may  be  able  to  find 
out  how  much  protein  she  is  furnishing  the  members 
of  her  family.  This  we  shall  discuss  further  in  the 
next  chapter. 


"  All  that  is  taken  into  the  stomach  above 
that  which  the  system  can  convert  into  good 
blood,  clogs  the  living  machine. 


"  The  system  receives  less  nourishment  from 
too  great  a  quantity  of  food,  even  of  the  right 
quality,  than  from  a  moderate  quantity  taken 
at  regular  intervals." —  White. 


CHAPTER  VI 
A  BALANCED  RATION  —  PROTEIN 

Ample  Supply  Important 

As  has  been  made  plain  in  previous  chapters,  it  is 
very  necessary  that  the  supply  of  oxidizable  food  be  cor- 
rect, not  only  as  to  total  amount,  but  also  as  regards 
proper  balance.  Each  article  of  food  eaten  should  bear 
its  proper  relation  to  all  the  others,  and  to  the  entire 
intake  for  the  meal.  While  this  is  true  of  all  the  food 
elements,  it  is  undoubtedly  in  the  normal  adjustment  of 
the  protein  part  of  the  diet  that  mistakes  are  most  often 
made  and  with  the  most  serious  results.  While  an  ex- 
cess of  fat  is  harmful,  yet  a  comparatively  small  amount 
may  not  be  deleterious,  providing  it  is  of  the  right 
kind  and  the  necessary  food  units  are  made  up  in  car- 
bohydrates. But  with  the  protein,  error  may  easily  be 
made  on  either  side,  and  while  much  has  been  said  in 
regard  to  protein  in  excess,  q'uite  as  much  stress  should 
be  laid  on  the  importance  of  getting  enough. 

Tissue  repair  being  dependent  upon  nitrogen,  it  is  ob- 
vious that  enough  protein  is  needed  in  the  food  to  supply 
the  necessary  nitrogen  to  rebuild  worn-out  cells.1  The 


1  The  normal  adult  body  should  be  kept  in  nitrogenous  equilibrium,  i.  e.,  the 
protein  intake  equal  to  the  outgo.  The  intake  is  proportionate  to  the  food  ingested  ; 
the  outgo  is  indicated  by  the  nitrogen  eliminated  in  the  urine,  which  can  be  de- 
termined by  laboratory  tests.  The  body  is  out  of  nitrogenous  equilibrium  when  the 
protein  intake  is  not  sufficient 'to  replace  worn-out  tissue,  as  in  cases  of  depleted 
food  supply,  or  in  disease  with  insufficient  food  ingestion  or  assimilation.  Here 
the  intake  is  less  than  the  outgo,  and  if  continued,  death  must  finally  result. 

The  body  is  also  out  of  nitrogenous  equilibrium  when  protein  is  used  not  only 
to  replace  worn-out  cells,  but  also  to  construct  new  tissue.  This  is  the  case  in 
convalescence  from  wasting  disease,  as  in  fevers,  tuberculosis,  etc.  In  these  cases 
the  ingestion  is  in  excess  of  the  elimination,  and  should  continue  so  until  a  normal 
balance  is  reached.  Normally  the  growing  child  takes  in  more  protein  than  is 
eliminated,  because  of  continually  developing  cells  and  tissues.  Here  again  the 
body  is  out  of  nitrogenous  equilibrium,  but  necessarily  so,  and  should  be  on  the 
safe  side  of  an  ample  supply.  In  some  cases  of  suboxidation  the  nitrogen  eliminated 
is  less  than  the  amount  ingested,  because  of  an  excessive  intake  and  insufficient 
activity  of  the  organs  of  elimination.  This  lack  of  balance  is  abnormal  and  re- 
sults in  disease. 

38 


A    BALANCED    RATION  —  PROTEIN  39 

ideal  balance  is  the  one  that  supplies  to  the  tissues  the 
amount  and  kind  of  protein  essential  for  its  specific  pur- 
pose and  not  a  great  deal  in  excess  of  that  amount. 
Protein  cannot  be  stored  in  the  tissues  in  excess,  and  so 
must  be  supplied  to  the  body  in  regular  daily  amounts, 
the  amount  needed  varying  within  much  narrower  limits 
than  that  of  fat  and  carbohydrate  and  much  less  depend- 
ent upon  varying  conditions  of  exercise. 

Protein  Ration  Constant 

Unless  engaged  in  very  active  muscular  exercise,  2,000 
to  2,500  food  units  is  sufficient  for  the  person  of  average 
height,  and  many  leading  sedentary  lives  do  much  better 
on  from  1,600  to  1,800  in  twenty-four  hours.  All,  how- 
ever, need  from  200  to  300  calories  daily  of  protein.  If 
one  requires  2,000  calories  total  and  200  calories  of  pro- 
tein, the  amount  of  protein  necessary  would  be  1-10,  or 
10  per  cent  of  the  total  ration.  But  if  an  individual  of 
sedentary  habits  needs  only  1,600  calories,  total,  he 
would  still  need  the  200  protein  units,  making  his  nec- 
essary protein  121/2  per  cent.  It  is  very  important,  then, 
to  bear  in  mind  that  the  amount  of  protein  should  re- 
main comparatively  constant,  and  that  if,  for  any  reason, 
the  total  food  intake  be  low,  the  protein  must  not  be 
materially  reduced. 

This  is  well  illustrated  in  the  treatment  of  obesity.  If 
the  daily  amount  of  protein  be  kept  up  to  nearly  normal, 
a  marked  reduction  in  the  total  food  intake  may  be  made 
without  inconvenience  to  the  patient.  (See  footnote  2, 
page  31.) 

An  Obesity  Cure 

On  a  ration  of  1,000  or  1,200  food  units  daily,  includ- 
ing the  needed  protein,  200  to  250  calories,  a  weekly 
loss  in  weight  of  two  to  four  pounds  may  be  accom- 
plished and  the  individual  not  suffer  from  hunger,  but 


40  THE    HOME   DIETITIAN 

maintain  his  strength  and  discharge  his  regular  daily 
duties.  In  fact,  the  body  being  gradually  relieved  of  an 
unnecessary  burden,  various  associated  ailments  due  to 
suboxidation  (see  Chapter  IV)  disappear  and  one  feels 
well  rewarded  for  any  self-denial  necessitated.  Such  a 
regimen  should,  however,  be  carried  out  under  the  su- 
pervision of  a  physician,  and  is  often  combined  with 
graduated  exercise  and  tonic  baths. 

An  abnormally  low  protein  aliment  leads  to  anemia, 
tuberculosis,  malnutrition,  nervous  exhaustion,  and  other 
chronic  and  functional  disorders. 

How  to  Know 

But  how  may  we  know  whether  or  not  our  protein 
ration  is  properly  related  to  our  total  daily  intake?  By 
referring  to  the  tables  of  food  values  as  given  in  the 
Appendix  the  percentage  of  protein  in  various  foods 
may  readily  be  seen,  and,  with  a  knowledge  of  these  pro- 
portions, the  higher  protein  foods  may  be  combined  with 
the  foods  lower  in  nitrogen  in  such  a  way  as  to  main- 
tain the  necessary  protein  percentage,  thus  giving  to  the 
body  this  tissue-building  element  in  the  normal  amount. 

Overeat  and  Undereat  at  the  Same  Time 

Those  who  partake  freely  of  meat  are  in  no  danger  of 
deficiency  in  protein,  their  danger  lies  in  getting  an  over- 
supply;  but  vegetarians  often  make  the  mistake  of  un- 
balancing their  daily  ration  so  as  to  overeat  and  to 
undereat  at  the  same  time.  Their  foods  are  often  com- 
bined in  such  a  way  that  it  is  necessary  for  them  to 
overeat  of  the  total  amount  in  order  to  obtain  the  body 
requirement  of  nitrogenous  food;  thus  we  frequently 
find  such  an  individual  poorly  nourished  and  unsatisfied, 
while  at  the  same  time  he  suffers  the  effects  of  overeat- 
ing and  indigestion. 


A    BALANCED    RATION  —  PROTEIN  41 

Protein  Balance  Disturbed 

In  the  preparation  of  food  the  protein  balance  is  often 
disturbed  by  the  addition  of  an  excess  of  fat  or  sugar 
or  both.  Take  for  example  an  Irish  potato  containing 
100  calories,  ten  calories,  or  10  per  cent,  of  which  are 
protein.  Add  to  this  50  calories  of  butter.  The  protein 
calories  still  remaining  ten,  the  percentage  of  protein  is 
now  6%.  Likewise,  beans,  always  considered  a  high  pro- 
tein dish,  may  be  made  relatively  a  medium  or  even  a  low 
protein  food  by  the  addition  of  a  free  amount  of  fat  in 
their  preparation.  An  ordinary  serving  of  oatmeal  with 
whole  milk  contains  about  150  calories,  of  which  27 
calories,  or  18  per  cent,  are  protein.  If  to  this,  50 
calories  of  sugar  are  added,  and  cream,  with  its  high 
percentage  of  fat,  is  used  instead  of  milk,  the  serving 
has  been  reduced  from  a  high  to  a  low  protein  dish,  the 
amount  of  protein  being  even  as  low  as  8  per  cent  of 
the  total  food  units.  If  cream  were  used  but  no  sugar, 
the  percentage  of  protein  would  drop  to  9!/2-  The  addi- 
tion of  the  cream  and  sugar  greatly  increases  the  total 
food  value  without  adding  any  protein. 

Bread  as  a  Protein  Food 

Even  the  homely  but  much  depended  upon  article  of 
diet,  bread,  has  a  goodly  proportion  of  protein,  12  to  16 
per  cent.  (See  table,  Appendix.)  But  as  ordinarily 
eaten  with  butter,  marmalade,  or  jelly,  it  descends 
greatly  in  the  scale  as  a  protein  food.  For  example, 
one  slice  of  whole-wheat  bread  equals  100  calories,  of 
which  15  calories  are  protein.  Adding  to  this  50  calories 
of  butter,  the  total  food  value  becomes  150;  the  protein 
calories,  still  15,  make  the  relation  of  protein  to  the 
total  just  10  per  cent.  Foods  served  in  this  way  may 
be  most  excellent  foods,  but  if  every  dish  is  so  prepared 
that  it  contains  10  per  cent  or  less  protein,  it  is  quite 


42  THE    HOME    DIETITIAN 

evident  that  there  is  great  danger  of  the  protein  intake 
being  too  low,  unless  the  entire  food  ration  be  kept  high, 
which  might  in  many  cases  make  the  total  more  than 
necessary  for  body  needs. 

Then,  too,  it  must  be  remembered  that  many  foods,  as 
fruit,  desserts,  sweets,  etc.,  contain  practically  no  pro- 
tein, so  that  somewhere  in  the  daily  ration  there  must 
be  food  containing  much  more  than  10  per  cent  protein. 
When  energy  foods  are  taken  in  concentration,  it  is  nec- 
essary to  use  concentrated  protein  food  in  the  form  of 
meat,  milk,  or  eggs,  in  order  to  maintain  the  normal  pro- 
tein balance.  This  is  one  reason  for  the  need  of  milk 
and  eggs  in  the  diet  of  the  ordinary  vegetarian.  The 
converse  is  obvious.  If  one  is  to  limit  his  concentration 
of  protein  food,  and  this  is  in  many  cases  desirable,  he 
must  minimize  the  amount  of  his  concentrated  energy 
food,  deriving  his  necessary  calories  from  natural  un- 
refined products.  (See  page  211.) 

The  Brain  Worker 

We  may  consider  as  an  exception  to  this  the  farmer 
who  needs  from  3,000  to  3,500  food  units  daily,  or  per- 
haps more.  He  easily  gets  his  necessary  250  to  300 
calories  protein,  even  while  living  on  medium  and  low 
protein  foods.  He  uses  up  the  excess  of  carbohydrate 
and  fat  in  the  energy  he  expends  in  his  active  labor ;  but 
the  one  who  needs,  because  of  a  sedentary  life,  to  be 
careful  not  to  overeat,  must  take  foods  richer  in  protein. 
Brain  workers,  or  those  who  expend  nervous  rather  than 
muscular  energy,  need  a  comparatively  high  protein 
ration  with  a  low  total  intake;  for  while  they  need 
nearly  as  much  protein  as  the  farmer,  they  may  need 
only  about  half  his  total  number  of  calories.  They  must 
maintain  a  protein  balance  of  1:6  or  1 :  8,  perhaps,  in- 
stead of  1 :  9  or  1 :  10.  They  must,  therefore,  live  on  the 
higher  protein  foods. 


A    BALANCED    RATION  —  PROTEIN  43 

The   Convalescent 

A  person  convalescing  from  a  wasting  disease  must 
have  ample  protein  to  rebuild  tissue,  but  often  his  di- 
gestive organs  are  not  equal  to  the  task  of  caring  for  a 
total  amount  of  2,000  or  more  calories.  So  the  diet  for 
such  a  one  must  be  so  planned  that  the  proportion  of 
the  tissue-building  elements  be  high  in  order  that 
enough  of  this  may  be  supplied,  even  though  the  entire 
daily  intake  must  of  necessity  be  lower  than  normal. 

If  You  Are  Too  Thin 

Many  thin  people  would  gain  in  weight  more  readily 
on  a  diet  supplying  a  goodly  amount  of  protein,  with  less 
of  the  carbohydrate  and  fat  and  even  a  low  total  daily 
ration,  than  on  one  in  which  the  entire  food  intake  is 
pushed  to  an  extreme  degree,  imposing  an  extra  tax  on 
the  digestive  organs  in  their  effort  to  care  for  an  exces- 
sive amount  of  food  material  which  never  can  be  got 
ready  for  absorption  and  utilization  by  the  tissues. 

Complete   Proteins 

There  is  another  important  phase  of  the  protein  ques- 
tion that  must  be  considered.  We  have  referred  in 
Chapter  II  to  the  complex  structure  of  proteins  and  to 
the  fact  that  complete  proteins  contain  some  seventeen 
nitrogenous  combinations  called  amino  acids.  These 
seventeen  parts  may  be  arranged  in  many  different  ways 
to  form  various  kinds  of  body  tissue.  Proteins,  in  order 
to  repair  every  kind  of  tissue,  must  contain  all  of  these 
seventeen  units,  and  such  proteins  are  said  to  be  com- 
plete. There  are  other  proteins  in  which  some  of 
these  important  combinations  of  nitrogen,  or  "  building 
stones,"  are  missing  and  so  are  incomplete.  Some  of  the 
important  amino  acids  are,  tyrosine,  tryptophane,  leu- 
cine,  lysine,  glycocoll,  cystine,  histidine,  and  arginine. 


44  THE    HOME   DIETITIAN 

Quality  as  Well  as  Quantity 

It  is  quite  evident,  then,  that  all  proteins  are  not  of 
equal  value  to  the  body  and  that  a  diet  may  be  deficient 
in  the  quality  of  its  protein  as  well  as  in  the  quantity. 
While  this  question  is  not  yet  fully  understood,  never- 
theless, as  the  result  of  animal  experimentation,  some- 
thing of  the  nature  of  the  various  food  proteins  has  been 
ascertained.  For  example,  it  has  been  shown  that  some 
proteins  will  maintain  but  will  not  induce  growth.  Rats 
fed  on  corn  fail  to  grow,  but  develop  properly  if  their 
diet  is  supplemented  by  casein  of  milk,  egg  yolks,  the 
proteins  of  other  seeds,  as  the  glutenin  from  wheat, 
glycinin  from  the  soy  bean,  globulin  from  squash  seed, 
globulin  from  cotton  seed,  excelsin  from  Brazil  nuts,  and 
globulin  from  maize,  or  corn.2 

Grain  Proteins 

It  has  been  found  that  an  animal  does  not  thrive  if 
fed  on  a  single  cereal  grain,  even  though  the  amount  of 
protein  be  theoretically  correct  and  the  total  food  units 
be  sufficient.  This  seems  to  be  due,  in  part  at  least,  to 
the  fact  that  many  of  the  grain  proteins  are  incomplete. 
This  does  not  mean  that  grains  are  not  good  foods,  but 
simply  that  the  diet  must  be  varied  enough  so  that  in- 
complete proteins  may  be  supplemented  by  complete  pro- 
teins or  with  proteins  supplying  the  missing  links. 


2  Quoting  from  L.  B.  Mendel,  who  has  done  much  work  along  this  line :  "  When 
the  gliadin  of  wheat,  a  prominent  protein  of  this  seed,  is  fed  as  the  sole  protein, 
adult  animals  are  suitably  maintained ;  but  growing  animals  cease  to  increase  in 
body  weight,  remaining  in  nutritive  equilibrium  without  growth  unless  the  amino- 
acid  lysine  is  added  to  the  gliadin  food.  Thereupon  growth  is  promptly  resumed. 
The  explanation  becomes  apparent  in  the  fact  that  gliadin  is  almost  entirely  de- 
void of  the  amino-acid  lysine ;  and  inasmuch  as  this  is  obviously  needed  for  new 
protein  construction,  growth  cannot  proceed  until  the  missing  unit  is  supplied. 
Again  zein,  the  most  conspicuous  protein  of  the  maize  kernel,  fails  to  yield  either 
lysine  or  tryptophane  or  glycocoll,  and  accordingly  is  entirely  inadequate  to  meet 
the  nitrogenous  needs  of  the  animals  in  respect  to  either  maintenance  or  growth. 
It  may  be  fed  in  the  greatest  abundance,  yet  the  animals  decline  in  health  unless 
the  zein  is  supplemented  by  some  more  perfect  protein.  If  the  amino-acid  trypto- 
phane is  added  to  the  imperfect  maize,  protein  maintenance  of  body  weight  without 
growth  is  promptly  established.  ...  If  both  tryptophane  and  lysine  are  added 
to  the  zein,  the  diet  thereupon  becomes  suitable  for  growth."  —  Journal  of  American 
Medical  Association,  Sept.  5,  1914. 


A    BALANCED    RATION  —  PROTEIN  45 

Combination    Important 

Two  proteins,  both  incomplete,  may  be  deficient  in 
different  ways  so  that  the  combination  of  two  or  more 
incomplete  proteins  may  be  sufficient  to  supply  all  the 
nitrogenous  combinations  and  thus  make  a  complete  pro- 
tein food.3 

The  Protein  of  Corn 

A  single  grain  usually  contains  more  than  one  protein, 
as,  e.  g.,  wheat  with  its  gliadin,  a  protein  that  will  main- 
tain body  weight,  and  its  glutenin,  one  which  will  stimu- 
late growth ;  and  while  zein,  a  prominent  protein  of  corn, 
is  unable  to  even  maintain  the  body,  yet  corn  also  con- 
tains protein  that  is  a  globulin,  which  will  maintain 
and  even  cause  growth.  If  intelligently  combined  with 
other  foods,  corn  is  a  valuable  addition  to  the  dietary. 
It,  however,  could  not  be  depended  upon  as  a  sole  source 
of  protein.  It  is  interesting  to  note  that  the  protein  of 
green  vegetables  will  supplement  the  protein  of  corn 
or  of  any  other  cereal. 

The  proteins  of  meat,  milk,  and  eggs  have  been  found 
to  be  complete  in  themselves.  Accordingly  a  diet  of 
grains  and  milk  is  a  complete  food  in  so  far  as  its  pro- 
teins are  concerned.  Recent  experiments  have  shown 
that  the  protein  of  the  peanut  and  the  soy  bean  are  of 
very  good  character. 

Know  Foods;   Avoid  Monotony 

Again  we  would  emphasize  the  need  for  a  knowledge, 
by  the  vegetarian,  of  foods  and  their  values,  that  the 
meatless  diet  may  not  prove  to  be  a  deficient  one.  A 
complete  diet  without  the  use  of  flesh  food  is  very  pos- 

3  The  proteins  of  the  pea  or  bean,  when  taken  as  the  sole  source  of  nitrogen, 
are  of  very  low  biologic  value,  and  they  will  not  supplement  the  protein  of  corn, 
though  they  improve  the  protein  of  wheat.  Bean  proteins  will  not  supplement  those 
of  oats,  though  pea  proteins  and  oat  proteins  are  said  to  supplement  each  other. 


46  THE    HOME   DIETITIAN 

sible  and  a  great  advantage,  but  care  must  be  taken  that 
intelligent  combinations  be  made  and  that  monotony  be 
avoided.  Green  vegetables  and  fruits  supply  many  ele- 
ments lacking  in  grains,  and  with  a  knowledge  of  food 
values  and  an  intelligent  daily  variation  in  foods  served, 
one  need  be  in  no  danger  of  limiting  his  diet  to  one  de- 
ficient either  in  quantity  or  quality  of  protein.  But  how 
important  that  the  housewife  be  educated  along  these 
lines  and  so  be  understandingly  efficient  as  she  carries 
on  the  important  work  of  supplying  the  family  table. 

Following  are  grouped  some  of  the  more  important 
staple  protein  foods  in  such  a  way  as  to  show  at  a 
glance  those  having  the  highest  proportion  of  the  ni- 
trogenous element.4  With  these,  many  attractive  dishes 
may  be  prepared,  and,  as  meat  substitutes,  supply  the 
necessary  protein. 

CLASS  1 

Very  high  protein  foods  (foods  of  high  total  food 
value  of  which  the  protein  is  above  20  per  cent). 

Food  Percentage  of  Protein 

Beans,  Lima   21 

Beans,  navy    25 

Beans,  kidney  or  pink 28 

Beans,   soy  °    32 

Buttermilk     23 

Eggs     33 

Cottage  Cheese 53 


4  The  percentages   of  protein  in   these   tables  are   of   the   total   food  values   and 
not  of  the  weight. 

5  Soy  beans,  introduced  into  the  United  States  more  than  one  hundred  years  ago, 
primarily  for  use  as  a  forage  crop,  are  in  reality  one  of  the  most  nutritious  of  the 
legumes   when  used  as   human   food,   according  to   specialists   of  the   United   States 
Department   of   Agriculture.    .    .    .    Since   they   furnish   proteins    and   valuable   fat, 
they  are  especially   important   to  turn  to  as    an   emergency  addition   to   the  usual 
dietary  or  as   a  substitute  for  other  foods  furnishing  protein  and  fat.     Moreover, 
the  fact  that  they  contain  no  starch  makes  them  valuable  for  invalids  who  cannot 
eat  starchy  foods.—  Food  Thrift  Series  No.  2,  U.  S.  Department  of  Agriculture. 


A   BALANCED    RATION  — PROTEIN  47 

Gluten  meal  or  flour  (40  per  cent)    ....  40 

Lentils    27 

Meat,  lean   33l/2tolOO 

Nuttolene 29 

Peas    25 

Protose     46.5 

Skim  milk   37 

CLASS  2 

High  protein  foods   (foods  with  high  total  food  value 
of  which  the  protein  is  from  15  to  20  per  cent). 

Food  Percentage  of  Protein 

Bread,  whole-wheat  16 

Gluten  meal  or  flour  (20  per  cent)    ....   20 

Granola    15 

Granuto    17 

Milk   (whole)    19 

Oatmeal    18 

Peanuts    20 

Rice    (whole)    16 

CLASS  3 

Medium    protein    foods    (foods   with  high   total   food 
value  of  which  the  protein  is  from  11  to  15  per  cent). 

Food  Percentage  of  Protein 

Almonds    15 

Bread,   rye    14 

Bread,  white  13 

Bread,  Graham    14 

Cracked  wheat  14 

Cream  of  Wheat  or  Farina 12 

Macaroni   14 

Shredded  Wheat  Biscuit 14 

Wheat   flakes  14 


48  THE  HOME  DIETITIAN 

CLASS  4 

Foods  with  low  total  food  value  of  which  a  high  pro- 
portion is  protein.6     See  Chapter  IX. 

Food  Percentage  of  Protein 

Asparagus    32 

Beets    24 

Cabbage  50 

Carrots     14 

Cauliflower    55 

Celery    24 

Cucumbers     20 

Eggplant 21 

Greens  —  beet,  dandelion,  etc 28 

Lettuce ' 25 

Radishes    18 

Spinach    32 

String  beans   40 

Tomatoes     21 

Turnips    20 


6  Complete  proteins,  or  proteins  containing  all  of  the  tissue  building  stones,  are 
found  in  the  foods  of  Class  4  as  well  as  in  the  outer  layer  of  all  other  vegetables, 
the  outer  layer  and  germ  of  grain,  and  in  milk,  eggs,  and  meat. 


"  Lack  of  balance  of  the  food  is  a  fault  sec- 
ond only  in  importance  to  actual  want  of  some 
essential  ingredient." —  McCarrison. 


CHAPTER  VII 

A    BALANCED    RATION    ( Continued )— FAT 

A  Concentrated  Fuel 

FAT  makes  up  an  important  part  of  the  dietary.  It  is 
fuel  for  the  body  in  a  concentrated  form.  It  contains 
carbon,  hydrogen,  and  oxygen,  and,  with  the  carbohy- 
drates, furnishes  heat  and  other  energy l  (see  page 
18)  in  its  oxidation  in  the  body. 

How  Much  Fat? 

Ordinarily,  about  one  fourth  to  one  third  of  the  food 
supply  should  be  fat,  or  from  600  to  800  calories.  Un- 
der conditions  where  the  body  fires  need  to  burn  more 
brightly,  as  in  cold  climates  or  in  excessive  exercise,  the 
body  needs  more  fuel,  and  so  can  utilize  and  take  care  of 
more  of  this  concentrated  food.2 

An   Excess 

However,  the  menu  of  the  average  family  contains 
much  more  of  this  food  element  than  the  one  third  given 
as  the  normal  proportion.  Instead  of  600  or  800  cal- 
ories, the  amount  usually  runs  up  to  more  than  1,000 
calories.  Four  hundred  to  600  food  units  of  butter  alone 
may  be  daily  consumed  by  the  one  who,  not  realizing  the 
need  for  a  more  nearly  balanced  ration,  carelessly  fol- 
lows his  inclination  in  this  respect.  When  to  this  is 


1  The   three  common   classes   of   fat   are,   stearin,   palmitin,   and   olein.      Stearin 
(CtjTHnoOo)    makes    up   a    large   part   of  beef   and   mutton   tallow,    and   having   a 
higher  melting  point  than  the  other  fats,  is  in  a  solid  form  at  ordinary  tempera- 
tures.    Palmitin   (C51H9sO«)   is  found  in  human  fat,  in  all  animal  fats,  and  to  an 
extent  in  vegetable  fats.     Olein  (Ca7Hio«O6).  having  a  low  melting  point  and  so  in 
the  form  of  oils,  is  found  to  a  greater  extent  in  vegetable  fats,  as  in  olive  and  cot- 
tonseed oils. 

2  Recent  scientific  investigation  goes  to  show  that  of  the  vitamines  essential  for 
life  some  are  soluble  in  fat,  and  of  the  fats  included  in  the  diet  some  should  be  in 
such  form  as  to  insure  the  provision  of  this  valuable  vitamine.      (See  Chapter  IX.) 

4  49 

• 


50  THE    HOME   DIETITIAN 

added  the  fatty  seasonings  in  the  other  foods  served,  the 
normal  fat  content  of  such  foods  as  olives  and  nuts, 
legumes  and  grains,  cream  and  milk,  the  excess  of  fat 
not  only  tends  to  bring  the  total  food  ration  far  above 
the  normal,  but  often  overwhelms  the  digestive  tract  and 
tissues  with  an  amount  of  fat  far  exceeding  the  ability 
of  the  body  properly  to  utilize  and  eliminate. 

Average  per  Capita 

Recent  calculations  show  that  the  average  consump- 
tion of  fat  per  capita  a  day  in  the  United  States  is  150 
grams,  which  equals  1,350  calories  daily.  (See  page  33.) 
While  Hoover  reports  that  during  his  two  years'  experi- 
ence in  Belgium  the  ration  allowed  contained  40  grams 
or  360  calories  of  fat,  60  grams  or  240  calories  of  pro- 
tein, and  300  grams  or  1,200  calories  of  carbohydrate, 
making  a  total  of  1,800  food  units  daily.  This  was 
found  entirely  sufficient  for  the  entire  population,  except 
for  adolescent  children,  for  whom  an  extra  allowance  of 
fat  was  made.  Surely  the  difference  between  the  360 
fat  units  actually  required  and  the  1,350  used  by  the 
American  people  represents  a  great  excess  in  the  use  of 
this  kind  of  food. 

Fat  Free  and  Combined 

Fat  is  supplied  to  us  in  two  forms :  free  fat  and  com- 
bined. Combined  fat  is  found  in  nuts,  olives,  grains, 
and  legumes,  especially  the  soy  bean.  It  is  also  found 
in  other  vegetables  and  in  some  fruits,  as  the  alligator 
pear.  Fat  is  not  found  in  nature  as  a  free  fat,  but  by 
mechanical  processes  can  be  isolated.  So  we  have  but- 
ter, oils,  free  animal  fats,  as  suet,  tallow,  lard,  etc.  The 
fat  of  cream  is  in  an  emulsified  form  and  is  not  a  free 
fat  until  it  is  made  into  butter. 

The  fat-soluble  vitamine  (see  Chapter  IX)  is  found  in 
milk,  eggs,  and  butter,  and  also  in  leafy  vegetables.  In 


A   BALANCED   RATION  —  FAT  51 

this  respect  it  becomes  largely  a  question  of  quality 
rather  than  of  quantity,  and  while  vegetables  cannot  be 
said  to  supply  fat  to  any  great  extent,  yet  they  contain 
a  sufficient  amount  to  hold  in  solution  this  valuable 
vitamine. 

Taking  a  hint  from  nature,  it  would  seem  that  the 
plan  was  not  for  our  food  to  contain  fat  in  a  free  state, 
but  in  a  form  which  could  more  readily  mix  with  the 
digestive  juices. 

In  the  stomach  an  excess  of  free  fat,  by  lubricating 
the  food  and  thus  preventing  its  mechanical  action,  hin- 
ders the  flow  of  gastric  juice  and  also  interferes  with 
the  thorough  mixture  of  the  digestive  fluid  with  the 
stomach  contents. 

Digestion   Hindered 

All  free  fat  must  be  thoroughly  emulsified  before  it 
can  be  digested  or  before  the  digestion  of  other  food 
elements  can  be  accomplished.  This  process  of  emulsi- 
fication  takes  place  in  the  intestine,  and  until  it  is  ac- 
complished all  digestion  is  to  a  greater  or  less  degree 
hindered.  This  is  particularly  true  of  protein.  The 
oily  coating  about  the  protein  particles  hinders  the  action 
of  intestinal  fluids  on  the  protein,  thus  furnishing  an- 
other factor  in  the  causation  of  intestinal  putrefaction 
and  auto-intoxication.  This  stagnation  also  allows  the 
fat  itself  to  become  rancid,  producing  products  irritating 
to  the  mucous  lining. 

Fat   Metabolism 

After  fat  is  digested  and  absorbed,  it  should  be  com- 
pletely oxidized  into  carbon  dioxide  (CO,)  and  water 
(H20),  with  resulting  heat  production,  and,  as  carbon 
dioxide  and  water,  eliminated  through  the  lungs,  skin, 
and  kidneys.  If  more  fat  is  ingested  than  can  be  oxi- 
dized into  CO2  and  H20,  one  of  two  things  happens: 


52  THE    HOME   DIETITIAN 

the  excess  is  laid  up  as  fat  in  the  tissues  with  perhaps 
resulting  obesity;  or  an  attempt  is  made  to  throw  off 
the  excess  in  an  imperfectly  oxidized  form,  and  again 
we  have  a  "  stove  that  smokes."  (See  page  20.) 

Fatty  Acids 

Fatty  acids  are  combinations  of  carbon,  hydrogen,  and 
oxygen  into  which  the  complex  fat  molecule  is  broken  up 
on  its  way  to  complete  disintegration.  To  an  extent 
they  are  formed  normally  in  the  process  of  fat  diges- 
tion. Abnormally  they  are  formed  when  fats  become 
rancid  either  on  the  pantry  shelf  or  in  the  digestive 
tract  as  the  result  of  delayed  digestion.  The  subjection 
of  fats  to  extreme  heat,  as  in  frying,  also  results  in  the 
formation  of  fatty  acids. 

Eczema,   Pimples,   Catarrh 

If  in  connection  with  metabolism  the  oxidation  of  fats 
is  incomplete,  the  process  often  stops  at  the  fatty  acid 
stage,  and  in  this  form  the  body  seeks  to  eliminate 
them.3  The  excretion  of  these  products  of  an  imperfect 
metabolism  takes  place  through  the  skin  and  mucous 
membranes,  and,  because  of  their  irritating  action,  they 
increase  the  tendency  of  a  susceptible  skin  to  eczema, 
acne,  pimples,  boils,  etc.,  and  of  the  mucous  membranes 
to  catarrh. 

This  result  is  often  made  the  more  probable  because 
of  the  accompanying  intoxication  resulting  from  the  in- 
testinal stasis  (stoppage)  brought  on,  or  increased  by 
the  presence  of  a  large  amount  of  free  fat  in  the  in- 
testinal canal. 

Frying 

These  conditions  of  irritation  are  increased  if,  before 
fats  are  eaten,  they  are  broken  up  by  heat  into  these 

3  This  excess  of  fatty  acids  in  the  blood  may  be  a  factor  in  the  production  of  a 
lessened  alkalinity  of  the  body  fluids,  often  spoken  of  as  acidosis.  (See  page  85.) 


A   BALANCED   RATION  —  FAT  53 

same  fatty  acids,  as  happens  in  most  frying  and  cooking 
at  extreme  heat.  This  decomposes  the  fat  so  that  it  at 
once  manifests  its  irritating  properties  as  it  reaches  the 
delicate  lining  of  the  stomach ;  and  at  the  same  time  the 
coating  of  fat  which  the  food  receives  in  frying  greatly 
hinders  the  mixing  of  the  gastric  juice  with  the  food 
particles. 

Quality  of  Fat 

The  amount  of  fat  needed  to  supply  caloric  needs  can 
be  supplied  the  body  in  the  form  of  olives  and  nuts,  and 
in  other  combined  forms,  without  the  use  of  fat  in  a 
free  state.  As  has  been  suggested,  quality  of  fat  must 
be  considered  as  well  as  quantity,  because  of  the  fact 
that  fat  is  an  important  vitamine  carrier.  An  excess  of 
refined  oils  cannot  take  the  place  of  fat  which  still  re- 
tains its  fat-soluble  vitamine.  If  a  sufficient  amount  of 
fat-soluble  vitamine  is  ingested,  the  need  for  additional 
fat  varies  largely  with  caloric  needs.  (See  page  77.) 

Butter 

Butter  differs  from  refined  oils  in  that  it  still  retains 
the  fat-soluble  vitamine  of  milk.  However,  the  milk 
supplies  this  vitamine  freely,  and,  as  has  already  been 
said,  this  vitamine  is  found  in  leafy  vegetables.  There- 
fore, with  a  diet  including  milk  and  leafy  vegetables, 
the  question  of  butter  in  the  daily  ration  becomes  one 
of  caloric  food  value  and  personal  taste.  The  advantage 
in  fat  as  a  food,  per  se,  is  in  the  fact  that  it  furnishes 
necessary  food  units  without  undue  bulk  with  its  tax  on 
the  mechanical  phase  of  digestion.  However,  as  we  have 
said,  combined  fats  may  accomplish  this,  in  most  cases 
quite  as  well  as  free  fats.  It  is  well  that  all  food  does 
not  come  to  us  in  a  bulky  form;  for  by  combining  bulk 
with  concentration  in  various  ways,  food  combinations 
suitable  for  all  types  of  individuals  may  be  supplied. 


54  THE    HOME   DIETITIAN 

The  fat  taken  in  olives  can  be  utilized  by  the  body  to 
much  better  advantage  than  if.  taken  as  olive  oil,  and  in 
the  olive  it  is  combined  with  mineral  salts  and  protein. 
For  those  who  need  for  a  time  an  extra  amount  of  con- 
centrated food,  cream  may  be  taken  with  advantage,  but 
this  can  easily  be  overdone. 

Vegetable  Oils 

It  is  a  fact  worthy  of  mention  that  the  vegetable  oils, 
especially  olive  oil,  are  not  so  quickly  broken  up  into 
fatty  acids  as  are  animal  fats,  more  particularly  butter. 
Butter,  being  rather  unstable,  quickly  becomes  rancid 
and  soon  decomposes  when  subjected  to  heat.  For  this 
reason  it  is  not  ideal  for  the  seasoning  of  cooked  foods, 
and  should  be  used  carefully.  This,  with  the  fact  that 
disease  of  animals  is  rapidly  on  the  increase,  makes  the 
question  of  the  free  use  of  butter,  one  not  only  of  econ- 
omy, but  also  of  health. 

Whenever  fat  is  used  as  seasoning,  it  is  much  better 
to  add  it  after  the  food  has  been  removed  from  the  fire, 
so  that  it  may  not  be  subjected  to  intense  heat.  The 
addition  of  fat  to  vegetables  greatly  lessens  their  di- 
gestibility, and,  if  cooked  properly,  it  is  surprising  how 
palatable  such  foods  are  without  the  addition  of  butter 
or  oil. 

To  Fry  Without  Grease 

Instead  of  the  excessive  use  of  fats  in  frying,  equally 
satisfactory  results  may  be  obtained  by  braising  or  broil- 
ing, using  only  enough  fat  to  slightly  oil  the  pan.  Even 
an  egg  may  be  "  fried  "  without  grease  by  dropping  it 
onto  a  perfectly  smooth  hot  iron  or  aluminum  skillet. 

So  then,  the  ideal  in  our  dietetic  program  which  is  to 
make  for  health  is,  first  to  balance  properly  our  daily 
fat  ration;  second,  to  eat  the  minimum  amount  of  free 
fat;  and,  third,  to  eliminate,  as  far  as  possible,  the  use 


A   BALANCED   RATION  —  FAT  55 

of  fried  or  greasy  foods.  With  a  little  interest  and  care 
we  shall  find  it  possible,  and  quite  as  easy,  to  prepare  our 
foods  in  a  way  that  will  yield  results  in  added  health, 
and,  at  the  same  time,  satisfy  the  most  epicurean  taste. 

Apropos  of  our  discussion  in  this  chapter,  we  quote  a 
portion  of  an  editorial  in  the  Journal  of  the  American 
Medical  Association,  March  5,  1921.  The  Journal  would 
not  wish  to  be  quoted  as  advising  a  food  intake  too  low 
in  fat,  as  is  indicated  in  the  last  paragraph  of  the  quo- 
tation. Nor  do  we;  our  only  plea  is  that  more  of  the 
fat  be  taken  in  its  natural  combined  form.  The  quota- 
tion, however,  is  of  interest  and  will  bear  study.  It 
suggests,  at  least,  the  possibility  that  fat  in  the  amounts 
we  have  been  accustomed  to  is  unnecessary. 

"  Some  of  the  physical  ills  which  visited  the  underfed 
peoples  of  the  war  were  charged  to  the  shortage  of  fats 
in  the  ration.  War  edema  serves  as  an  illustration. 
Subsequent  investigation  has  failed  to  justify  most  of 
these  offhand  conclusions. 

Psychologic   as    well   as   Physiologic 

"  That  fat  is  a  potent  food,  is  obvious  from  a  consid- 
eration of  its  fuel  value  alone.  A  pound  of  fat  yields 
two  and  one-fourth  times  as  much  energy  as  does  a 
pound  of  any  other  nutrient  utilized  by  man.  This  was 
the  physiological  justification  for  the  slogan:  '  Fats  Are 
Fuel  for  Fighters/  A  study  of  the  dietary  habits  of 
different  races  at  once  suggests,  however,  that  the  ap- 
parent dependence  of  persons  on  fats  may  have  psycho- 
logic or  culinary  motives  as  well  as  purely  physiologic 
reasons.  Thus,  we  are  reminded  that  the  Japanese,  for 
example,  habitually  eat  little  fat.  But  it  is  the  habit  of 
both  Europeans  and  Americans  to  use  considerable  fat, 
both  on  the  table  and  in  cooking.  The  taste  of  food  is 
not  so  pleasing  without  it.  Their  recipes  almost  all  call 


56  THE    HOME   DIETITIAN 

for  fat  in  one  form  or  another,  so  that  when  little  or 
none  is  available,  a  change  must  be  made  in  most  of  the 
methods  of  cooking.  Virtually  all  food  must  be  boiled, 
and  is  lacking  in  the  flavor  and  texture  to  which  we  are 
accustomed.  The  food,  no  matter  how  nutritious  it  may 
be,  will  not  taste  good.  In  other  words,  food  without 
fat  is  likely  to  be  without  flavor  and  monotonous;  and 
if  a  food  is  distinctly  unpleasant  and  different  from 
what  a  person  is  accustomed  to,  digestive  upsets  may 
result. 

An  Important  Query 

"  Accordingly,  when  those  concerned  with  the  nutri- 
tive welfare  of  the  nation  raised  the  query,  '  How  much 
fat  do  we  need? '  the  reply  was  that  '  it  is  impossible  to 
say  with  definiteness.'  The  fact  that  there  has  been  no 
available  satisfactory  information  on  this  question  is  at- 
tributable to  the  experimental  difficulties  heretofore  in- 
herent in  its  solution.  It  is  only  in  comparatively  recent 
times  that  some  of  the  essentials  of  an  adequate  diet 
have  been  discovered.  Without  knowledge  of  the  impor- 
tance of  vitamines,  for  example,  all  earlier  attempts  to 
study  the  role  of  proteins,  fats,  carbohydrates,  or  in- 
organic components  of  the  diet  by  feeding  them  in  varied 
proportions  as  isolated  substances,  inevitably  failed.  A 
diet  rich  in  fat  might  bring  nutritive  failure  as  readily 
as  one  poor  in  this  foodstuff,  the  untoward  outcome  in 
either  case  being  due  to  a  neglected  and  unrecognized 
further  factor  in  the  food  mixture.  Again,  the  presence 
of  fat  in  the  diet  might  bring  beneficial  results  because 
it  was  the  chance  carrier  of  vitamine  A,  associated  with 
some  fats  more  than  others.  [See  Chapter  IX.]  Mai- 
gnon  supposed  that  fats  assume  an  important  role  in  the 
utilization  of  protein,  a  role  that  carbohydrates  are  pow- 
erless to  fill.  His  experiments  were  conducted  by  feed- 
ing mixtures  of  more  or  less  isolated  food  materials 


A   BALANCED   RATION  —  FAT  57 

without   due   consideration   to   the  now   well-recognized 
need  of  accessory  food  factors  or  vitamines. 

"  Recent  controversies  regarding  the  necessity  for  fats 
in  the  diet  fail  to  emphasize  adequately  the  distinction 
in  the  significance  of  fats  as  sources  of  energy  and  as 
carriers  of  vitamine  and  of  lipoids,  regarding  the  role  of 
which  we  are  still  largely  uninformed.  Directing  atten- 
tion to  the  fats  themselves  rather  than  to  the  other  food 
ingredients  which  commonly  accompany  them,  Osborne 
and  Mendel  have  succeeded  in  securing  satisfactory 
growth  from  an  early  age  to  full  adult  size  in  experi- 
mental animals  on  rations  extremely  poor  in  true  fats. 
The  diets  consisted  of  mixtures  of  proteins,  starch,  and 
inorganic  salts,  vitamines  A  and  B  being  supplied  by 
small  portions  of  alfalfa  and  yeast.  Such  mixtures  are 
not  absolutely  devoid  of  extractable  fat,  but  the  maxi- 
mum of  the  latter  amounted  at  most  to  a  small  fraction 
of  1  per  cent  of  the  ration.  Hence  Osborne  and  Mendel 
cannot  avoid  the  conclusion  that  if  true  fats  are  essential 
for  nutrition  during  growth,  the  minimum  necessary 
must  be  exceedingly  small.  .  .  .  Hindhede,  whose  re- 
sults with  young  men  correspond  to  observations  on 
laboratory  animals,  has  contended  that  fat  is  not  re- 
quired in  the  diet  if  a  sufficient  amount  of  fresh  fruits 
and  vegetables  is  eaten  daily  to  supply  vitamines.  The 
striking  facts  here  offered  must  not  be  accepted  as  an 
immediate  dictum  that  dietary  fats  ought  to  be  dispensed 
with,  .  .  .  nor  do  they  demonstrate  that  well-being  is 
not  best  promoted  by  the  inclusion  of  a  liberal  quota  of 
fats  in  our  daily  intake.  They  are  physiologic  facts 
with  which  the  study  of  nutrition  may  henceforth  deal." 

"  Consider  diligently  what  is  before  thee:  and 
put  a  knife  to  thy  throat,  if  thou  be  a  man 
given  to  appetite." — Bible. 


CHAPTER  VIII 

CARBOHYDRATES;   THEIR  PLACE  IN  THE 
DAILY  RATION 

THE  total  food  ration  being  kept  near  normal  limits 
and  fat  and  protein  taken  in  proper  amounts,  the  ques- 
tion of  the  proportion  of  carbohydrate  obviously  takes 
care  of  itself;  but  there  are  a  few  things  in  regard  to 
this  important  fuel  food  that  should  be  kept  in  mind. 

Cellulose 

The  great  bulk  of  food  is  carbohydrate,  one  of  the 
seven  great  food  classes.  To  this  class  belong  cellulose, 
starch,  and  sugar.  Cellulose  is  not  digested  and  serves 
merely  as  bulk,  but  when  acted  upon  by  strong  acids,  it 
may  be  changed  from  cellulose  to  starch;  from  starch, 
through  the  stages  of  dextrin  and  maltose,  to  glucose,  the 
simple  sugar  which  practically  all  digestible  carbohy- 
drate becomes  before  it  is  absorbed  from  the  intestinal 
tract.  (See  page  60.)  All  plant  fiber  is  cellulose,  the 
woody  framework  of  trees,  and  even  cotton.  A  story 
is  told  of  a  man  who  took  a  dirty  shirt  which  had  been 
worn  by  a  tramp,  and,  after  washing  it,  put  it  through 
various  processes  which  changed  it  from  the  cellulose 
which  it  really  was,  into  glucose,  from  which  he  made 
a  delicious  confection.  However,  the  digestive  tract 
cannot  digest  cellulose,  so  it  passes  through  unchanged, 
simply  serving  as  a  broom  to  keep  the  bowel  clean  and 
as  bulk  upon  which  this  muscular  tube  can  exercise  itself. 

Starch 

Starch  is  the  form  in  which  carbohydrate  is  first  man- 
ufactured in  the  plant.  Unripe  fruit  contains  starch, 

58 


CARBOHYDRATES  59 

but  as  the  fruit  ripens,  this  starch  is  changed  to  sugar. 
This  fruit  sugar  is  made  up  principally  of  glucose  or 
dextrose  and  a  closely  related  sugar  of  practically  the 
same  chemical  composition  called  levulose.  In  vegeta- 
bles, starch  is  stored  up  in  the  plant,  only  a  small  por- 
tion of  it  becoming  sugar.  The  carbohydrate  of  grains 
is  mostly  in  the  form  of  starch. 

Sugar  is  found  principally  in  fruits,  honey,  the  sugar 
cane,  the  maple,  and  some  vegetables,  as  the  sugar  beet. 
The  important  difference  between  starch  and  sugar  is 
that  starch  must  be  changed  into  sugar  during  the  process 
of  digestion.  The  formation  of  dextrin  is  the  first  step 
in  the  process  of  changing  starch  into  sugar.  (See 
page  14.)  Maltose  is  the  next  step.  Maltose  is  formed 
in  the  malting  of  grains,  during  thorough  mastication, 
and  in  the  intestine,  where  the  process  of  starch  diges- 
tion is  completed  by  action  of  the  amylopsin  of  the  pan- 
creatic juice.  Maltose  is  then  changed  into  glucose  in 
the  intestine.1  So  in  this  process  we  have  starch,  dex- 
trin, maltose,  glucose. 

The  process  of  digestion  completed,  carbohydrate  is 
absorbed  in  the  form  of  glucose.  It  is  then  changed  in 
the  liver  to  a  form  called  glycogen,  and  is  dealt  out  to 
the  body  as  it  is  needed. 

Sugar 

The  forms  of  sugar  as  we  find  them  in  various  foods 
may  be  classified  as  (1)  dextrin  (the  first  step  in  starch 
digestion,  as  in  dextrinized  foods)  ;  (2)  maltose  (the 
second  step  in  starch  digestion,  found  in  meltose,  malt 
sugar,  dextri-maltose,  etc.)  ;  (3)  glucose  (the  final  step 

*The  chemical  formula  for  starch  is  (C6H10OB)n;  for  dextrin,  (CeH10O6)n; 
for  maltose,  C12H22On  ;  for  cane  sugar,  Ci2H22Oti  ;  for  dextrose,  or  glucose, 
CeHioOo.  The  change  from  starch  into  sugar  may  be  represented  by  the  following 
chemical  equation:  2(C0Hi0Oe)  -f  H2O  =  C12H22Oii,  or  maltose.  The  change  from 
maltose  into  the  simple  sugar  glucose,  is  shown  by  the  following:  Ci2H22Oii  (mal- 
tose) +  H2O  (water)  =  CcH12Oo  (glucose)  +  CeHioOe  (glucose),  or  two  molecules  of 
glucose. 


60  THE    HOME   DIETITIAN 

in  starch  digestion,  often  called  dextrose  and  found  in 
fruit  sugar)  ;  (4)  levulose  (see  page  59)  ;  (5)  galactose 
(or  the  sugar  of  milk  and  akin  to  glucose)  ;  (6)  sucrose 
(cane  sugar,  the  most  complex  sugar  and  found  in  the 
sugar  cane,  sugar  maple,  and  sugar  beet) .  In  the  proc- 
ess of  digestion,  cane  sugar  is  changed,  with  other 
sugars,  into  glucose;  levulose  and  galactose,  being  chem- 
ically the  same  as  glucose,  remain  unchanged.  Honey 
is  a  combination  of  cane  sugar  and  fruit  sugar. 

In  the  tissues  the  oxidation  of  sugar  produces  heat  and 
energy,  and  it  is  eliminated  as  carbonic  acid  gas  (C02) 
and  water  (H20).  Normally  a  certain  amount  of  carbo- 
hydrate is  changed  over  into  fat  and  deposited  in  the 
tissues  as  reserve  fuel.  In  this  respect  carbohydrate  and 
fat  differ  from  protein,  in  that  protein  cannot  be  stored 
as  reserve  for  future  use. 

In  cases  of  suboxidation  due  to  lack  of  exercise,  or 
where  the  food  intake  is  in  excess  of  body  demand,  this 
storing  of  the  carbohydrate  in  the  form  of  fat  may  be- 
come excessive  and  obesity  may  result. 

Diabetes 

Diabetes  is  an  abnormal  condition  in  which  the  oxida- 
tion of  sugar  is  interfered  with,  and  sugar,  instead  of 
being  used  by  the  tissues,  is  dealt  with  by  the  blood  as 
a  foreign  substance,  and  being  eliminated  by  the  kid- 
neys as  glucose,  is  found  as  such  in  the  urine.  This 
metabolic  disorder  is  not  well  understood,  but  is  prob- 
ably due  to  some  abnormality  in  the  internal  secretions 
which  govern  the  oxidation  processes.  (See  Chapter 
XXVI.) 

The  amount  of  carbohydrate  food  required  by  the  in- 
dividual depends  upon  body  caloric  needs.  After  the 
necessary  200  to  300  calories  of  protein  have  been  as- 
sured, the  amount  of  energy  food  required  must  be  ap- 


CARBOHYDRATES  61 

portioned  between  carbohydrate  and  fat.  Because  of 
the  concentration  of  fat  and  the  fact  that  its  molecule 
is  more  complex  than  that  of  carbohydrate,  and  there- 
fore not  so  easily  digested  and  metabolized,  it  would  be 
unwise  to  attempt  to  derive  all  energy  material  simply 
from  fat. 

Bulk  Versus  Concentration 

Carbohydrates  in  their  natural  form  furnish  bulk 
minus  the  concentration  of  fat.  Therefore,  if  they  form 
too  small  a  proportion  of  the  diet,  the  system  may  suffer 
from  a  handicap  of  dealing  with  too  large  an  amount  of 
concentrated  food  with  its  greater  difficulty  of  both  di- 
gestion and  metabolism.  The  digestive  tract  is  so  con- 
structed that  it  works  better  with  food  which  furnishes 
considerable  proportion  of  bulk.  If  fat  were  depended 
upon  to  supply  this  bulk,  much  more  food  would  be 
taken  than  would  be  required,  and  because  of  the  con- 
centrated nature  of  fat,  digestion  would  be  well-nigh 
impossible.  Because  of  the  ease  of  the  oxidation  of  the 
carbohydrate  molecule,  carbohydrates  have  been  likened 
to  the  kindling  which  makes  it  possible  for  the  body 
fires  thoroughly  to  burn  fat,  the  more  concentrated  fuel. 

Protein  Sparer 

Carbohydrates  have  also  been  found  to  act  as  protein 
sparers,  i.  e.,  under  conditions  where  protein  must  be  in- 
gested in  smaller  quantities  than  normal,  it  is  possible 
for  the  carbon,  oxygen,  and  hydrogen  of  carbohydrates 
to  unite  with  the  outgoing  nitrogen,  which,  having  been 
used  once,  is  on  its  way  to  be  eliminated;  catching  it,  as 
it  were,  they  bring  it  back  to  do  second  duty.  In  this  way 
the  possibilities  for  the  use  of  nitrogen  under  such  cir- 
cumstances, are  doubled.  Hence,  while,  under  normal 
conditions,  we  need  400  to  600  calories  of  the  more 


62  THE    HOME   DIETITIAN 

concentrated  food,  the  greater  part  of  our  food  intake 
must  ever  be  carbohydrate,  say  1,000  to  1,500  calories. 
The  proper  variation  in  these  two  types  of  energy  food 
with  different  individuals  is  one  of  the  points  where  a 
careful  judgment  in  dietary  planning  is  often  needed. 
Some  do  better  with  more  concentrated  food  and  less 
bulk,  while  others  may  need  to  have  a  greater  amount 
of  their  food  value  in  a  bulky  form. 

In   Natural   Combination 

In  natural  unrefined  foods,  starch  is  always  in  com- 
bination with  vitamines,  mineral  salts,  and,  to  some 
extent,  complete  proteins.  These  important  associated 
elements  are  found  in  the  hull  of  the  grain  in  rice  pol- 
ishings,  the  skin  of  the  potato,  etc.  (See  Chapter  IX.) 
As  with  starch  so  with  sugar,  we  find  all  in  natural  com- 
bination with  vitamines  and  mineral  salts,  including  a 
goodly  supply  of  lime,  or  calcium.  We  have  seen  that 
fat  and  protein  are  not  supplied  in  nature  in  a  free  state. 
Natural  foods  are  ever  combined  in  the  way  most  ad- 
vantageous for  body  use. 

Nature  tends  to  avoid  concentration,  and  ever  asso- 
ciates with  foodstuffs  small  quantities  of  very  active  sub- 
stances which  help  to  bring  into  play  the  mechanism  that 
makes  it  possible  for  the  body  to  use  these  foods  to  the 
best  advantage.  We  find,  however,  in  civilized  countries, 
as  a  result  of  refining  processes,  these  accessory  elements 
largely  removed ;  so,  instead  of  honey,  with  its  associated 
vitamines  and  lime  salts,  instead  of  fruit  sugar  as  found 
in  fruit,  man  depends  almost  entirely  upon  the  refined 
form  of  cane  sugar  for  the  satisfaction  of  his  desire  for 
sweets.  We  find  him  taking,  as  he  does  his  fats,  much 
of  his  starch  in  refined,  concentrated  form,  such  as  white 
bread,  polished  rice,  and  the  potato  from  which  the  outer 
covering  has  been  removed.  (See  page  101.)  This  gives 


CARBOHYDRATES  63 

him  a  preponderance  of  carbohydrate  without  its  asso- 
ciated means  for  stimulating  normal  digestive  and  met- 
abolic processes.  This  is  therefore  the  reason  for  the 
recognized  difficulty  attending  the  digestion  of  so  much 
starchy  food.  It  is  not  only  concentrated,  but  devital- 
ized, and  cannot  be  well  handled  by  the  digestive  tract. 
Starch  requires  more  digestion  than  sugar,  as  it  is  in 
a  more  bulky  form,  thus  increasing  the  strain  on  the 
mechanical  phase  of  digestion,  and,  chemically  it  must 
be  changed  into  sugar  before  absorption.  If  this  tax  is 
placed  upon  the  digestive  powers  without  the  normal  at- 
tending vitalizing  elements,  small  wonder  that  fermenta- 
tion results,  with  the  formation  of  gases  and  irritating 
acids. 

Carbohydrate   Fermentation 

Fermentation  of  carbohydrate  in  the  digestive  tract, 
as  well  as  the  results  of  incomplete  metabolism,  draws 
upon  the  alkaline  resources  of  the  body,  often  causing  a 
tendency  to  acidosis,  so  called.  This  is  especially  true 
when  large  amounts  of  devitalized,  starchy  food  is  taken, 
or  when  concentrated  cane  sugar  is  ingested  in  more 
than  very  moderate  quantities. 

Says  Sir  James  Barr,  M.  D.,  of  England:  "An  ex- 
cessive amount  of  acid,  whether  taken  by  the  mouth  or 
generated  by  the  fermentation  of  carbohydrates  in  the 
stomach,  would  extract  the  lime  salts  from  the  bones, 
cartilages,  fibrous  tissues,  and  nerves.  The  acid  fermen- 
tation of  an  excess  of  carbohydrate  will  saturate  the  free 
calcium  ions,  and  even  dissolve  the  calcium  already  de- 
posited in  the  tissues."  (See  Chapter  X.) 

Moderation   Important 

This  discussion  may  help  to  make  clear  the  reason  for 
the  rather  bad  reputation  that  so-called  starchy  food  has 


64  THE    HOME   DIETITIAN 

acquired  in  the  minds  of  the  people.  There  are  many 
who  have  learned  that  starches  do  not  agree  with  them. 
Just  why,  they  do  not  know,  and  various  diet  enthusiasts 
think  to  solve  all  dietetic  problems  by  an  endeavor  to 
greatly  restrict  the  use  of  starchy  foods  or  even  to  elim- 
inate them  entirely.  So  we  hear  of  "  starch  poisoning," 
of  the  harm  of  taking  "  two  starches  at  a  meal,"  that 
"  potatoes  should  never  be  eaten,"  and  even  that  our  old 
stand-by,  bread,  is  "  the  staff  of  death."  Most  of  these 
people  have  a  very  vague  conception  of  food  values. 
They  do  not  know  that  of  necessity  starch  must  have  an 
important  place  in  the  food  ration  of  man,  and  that  the 
trouble  is  not  with  starch  as  a  food,  but  with  the  de- 
vitalized, demineralized  form  in  which  it  is  taken  and  in 
the  unbalancing  of  the  daily  ration  by  letting  exces- 
sive carbohydrate  crowd  out  necessary  protein.  They 
do  not  realize  that  actual  bulk  of  food  must  be  con- 
sidered as  related  to  the  mechanics  of  digestion;  that 
foods  containing  starch  —  such  as  bread,  potatoes,  rice, 
cereals,  legumes  —  furnish,  as  compared  with  such  foods 
as  fruits  and  vegetables,  a  concentrated  mass  which,  if 
taken  in  excess,  handicaps  digestion  in  both  its  mechani- 
cal and  its  chemical  phase  —  mechanical,  because  of  the 
difficulty  with  which  the  muscular  walls  work  over  this 
concentrated  mass;  and  chemical,  because  of  the  length 
of  time  it  may  take  the  digestive  juices  to  penetrate  the 
center  of  it.  Moderation  should  be  exercised  in  the 
eating  of  any  class  of  foods,  whether  starch,  sugar,  fat, 
or  protein,  as  overeating  of  any  food  is  bad,  including, 
of  course,  foods  containing  starch. 

So  let  these  foods,  which  are  so  important  and  yet 
against  which  so  much  has  been  said,  be  eaten  only  in 
proper  proportion;  let  them  be  combined  freely  with 
foods  that  supply  bulk  in  a  lighter,  less  concentrated 
form,  as  green  vegetables  both  raw  and  cooked,  salads, 


CARBOHYDRATES  65 

fruits;  and  by  all  means  let  them  be  taken  in  natural 
combination  as  intended  for  us  by  nature.  We  shall 
then  choose  Graham  and  whole-wheat  bread,  whole-grain 
cereals,  brown  rice;  and  in  preparing  vegetables  we 
shall  remember  the  value  of  the  salts  and  vitamines  just 
under  the  skin  and  in  the  leaves.  Let  it  be  remembered 
that  no  two  digestive  tracts  are  able  to  do  exactly  the 
same  work,  and  that  with  a  knowledge  of  the  under- 
lying principles,  all  rules  must  be  modified  to  suit  the 
individual. 

Undoubtedly  many  people  eat  too  much  bread,  cereal, 
and  potato;  too  large  a  proportion  of  these  foods  are  in 
their  diet,  with  not  enough  of  the  foods  supplying  com- 
plete protein,  mineral  salts,  and  vitamines.  They  are 
either  overeating  or  their  carbohydrate  food  is  crowding 
out  necessary  protein.  Let  these  matters  be  adjusted, 
and  starch  be  given  its  proper  place  as  an  important 
and  necessary  article  of  food. 

Cane  Sugar 

Another  devitalized,  demineralized,  concentrated  food 
taken  in  great  excess  by  civilized  peoples  is  cane  sugar. 
In  spite  of  the  abundance  of  the  natural  predigested 
sugar  of  fruit,  it  is  in  the  form  of  cane  sugar  extracted 
from  its  various  sources,  and  served  often  in  its  con- 
centrated form,  that  a  large  part  of  sugar  is  ingested. 
In  its  concentrated  form  cane  sugar  is  very  irritating 
to  the  mucous  membrane,  very  marked  inflammatory 
effects  being  produced  when  solutions  stronger  than  6 
per  cent  to  10  per  cent  are  taken.  Yet  it  is  in  this  form 
that  millions  of  pounds  a  year  are  consumed  by  the 
American  people,  and  to  this  excess  may  be  ascribed 
another  cause  for  various  digestive  troubles,  to  say  noth- 
ing of  an  excessive  fuel  supply  in  its  effect  on  metabo- 
lism. This  also  adds  to  conditions  of  fermentation  in  the 


66  THE    HOME   DIETITIAN 

digestive  tract,  with  a  formation  of  acids  which,  as  we 
have  seen,  tends  to  produce  conditions  of  acidosis.  In 
nature,  sugar  is  always  combined  with  lime.  If  ex- 
tracted from  the  lime  and  taken  in  a  refined  form,  it 
draws  upon  the  lime  reserve  of  the  body,  and,  as  we 
have  quoted,  may  even  dissolve  the  calcium  already  de- 
posited in  the  tissues.  As  calcium  salts  are  among  the 
important  alkalizers  of  the  body  fluids  as  well  as  im- 
portant structural  elements  in  the  formation  of  such 
tissues  as  the  teeth  and  bones,  we  can  see  a  reason  for 
the  well-known  deleterious  effect  excessive  candy  eating 
has  on  the  teeth  of  children,  and  for  the  frequency  of 
rickets  in  babies  on  a  diet  supplying  a  preponderance 
of  sugar,  as  in  certain  proprietary  infant  foods. 

The  Sweet  Tooth 

Children  are  educated  from  babyhood  to  like  sugar, 
and  "  the  sweet  tooth  "  so  universal  among  them  is  more 
often  a  result  of  wrong  training  than  a  natural  instinct. 
These  children  are  often  fat  and  apparently  well  nour- 
ished, but  their  vital  resistance  in  many  cases  is  low, 
and  they  may  be  among  the  first  to  succumb  to  in- 
fection and  disease.  The  susceptibility  of  the  child  to 
colds,  catarrh,  adenoids,  enlarged  tonsils,  croup,  bron- 
chitis, is  often  greatly  increased  by  this  error  in  diet, 
with  an  excess  of  fats  and  greasy  foods.  Wise  is  the 
mother,  who,  knowing  this,  feeds  her  child  in  such  a 
way  that  the  foundation  for  chronic  catarrh,  digestive 
troubles,  and  metabolic  disturbances  is  not  laid. 

Cane  Sugar  Formerly  Not  Used 

We  quote  from  Dr.  Kerley,  of  New  York: 
"  Cane  sugar  was  not  cultivated  until  three  hundred 
years  ago,  and  as  late  as  the  tenth  century  it  was  used 
largely  as  a  condiment  as  honey  is  used  at  the  present 


CARBOHYDRATES  67 

time.  Countless  millions  existed  and  lived  their  span 
without  it.  Now  we  require  forty  pounds  2  a  year  per 
capita.  It  requires  no  great  strain  on  the  imagination 
to  believe  that  the  introduction  of  so  large  an  amount 
of  highly  energized  food  in  excess  of  demands  might 
produce  ailments  of  a  very  definite  character.  It  is  note- 
worthy that,  as  the  refined  product  came  into  common 
use,  it  was  first  employed  only  on  medicine  '  to  render 
unpleasant  and  nauseating  drugs  grateful  to  the  sick.' 
Gradually  sugar  was  found  of  value  in  preserving  fruits, 
and  then  added  to  tea,  wine,  and  various  beverages,  un- 
til its  acceptability  as  a  food  for  the  sick  and  its  value 
as  a  source  of  energy  in  sustaining  artificially  fed  in- 
fants came  to  be  appreciated.  Then  only  (about  1600) 
was  the  substance  commonly  recognized  as  a  food. 
What  the  result  has  been  cannot  be  better  summarized 
than  in  the  words  of  Moseley,  written  in  1800: 

"  '  Two  centuries  have  elapsed  since  it  can  properly 
be  said  that  sugar  has  become  an  ingredient  in  the  popu- 
lar diet  of  Europe.  Such  is  the  influence  of  sugar  that 
once  touching  the  nerves  of  taste,  no  person  was  ever 
known  to  have  the  power  of  relinquishing  desire  for  it.' ' 

We  q'uote  also  from  Fitch,  in  "  Dietotherapy,"  Volume 
II,  page  766: 

"  It  will  be  observed  that  Mendel  appears  skeptical  as 
to  white  sugar  being  of  any  great  nutritive  value,  but 
does  not  comment  on  the  cream-colored  product. 

"  Campbell  .  .  .  propounded  as  iconoclastic  opin- 
ions with  regard  to  the  food  value  of  sugar  as  he  pro- 
pounded concerning  milk.  He  stated  that  we  could  get 
on  very  well  without  sugar  at  all.  Primitive  man  had 
none  but  the  limited  quantity  furnished  by  wild  honey. 
War  prices  are  exorbitantly  high,  and  it  consequently 
behooves  every  one  to  be  economical.  He  maintained 


2  This  is  now  ninety  pounds  a  year. 


68  THE   HOME  DIETITIAN 

that  all  money  spent  on  candy  is  worse  than  wasted,  and 
recommended  that  none  should  be  so  spent,  that  the 
money  saved  in  this  way  should  be  loaned  to  the  state, 
and  that  the  multitude  of  persons  engaged  in  the  sweet 
industry  should  be  transferred  to  occupations  more  prof- 
itable to  the  country. 

"  More  than  one  well-known  physiological  authority 
has  stated  that  sugar  is  not  a  natural  food,  inasmuch 
as  the  human  economy  is  constructed  to  convert  carbo- 
hydrate, e.  g.,  starch,  which  they  claim  to  be  a  natural 
foodstuff,  into  sugar.  It  is  certain  that  if  sugar  were 
tasteless  or  not  sweet,  it  would  not  be  so  popular  as  it 
is,  and  thus  it  must  rank  as  a  condiment  as  well  as  a 
food.  It  is  interesting  to  recall  that  sugar  was  scarcely 
a  commercial  commodity  a  little  over  a  century  ago,  and 
that  before  that  our  ancestors  got  on  very  well  without 
it,  while,  as  a  matter  of  fact,  a  big  section  of  the  com- 
munity consumes  nowadays  very  little  or  none  of  it. 
The  history  of  starch  in  the  dietary,  on  the  other  hand, 
goes  back  to  the  very  beginning  of  things,  and  there  was 
a  supply  of  starches  long  before  sugar  was  thought  of  in 
its  present  form. 

"  Custom  and  cheapness  have  brought  sugar  into  wide 
use,  but  in  time  of  war  its  employment  in  many  ex- 
traneous and  totally  unnecessary  ways  should  be  pro- 
hibited. After  all,  diet  is  largely  ruled  by  custom,  and 
war  has  gone  to  show  that  many  customary  articles  of 
food  which  were  considered  essential  by  the  public  can- 
not only  be  dispensed  with,  but  be  dispensed  with  to 
the  benefit  of  the  general  health." 


"  Many  things  sweet  to  taste,  prove  in  diges- 
tion sour." —  Shakespeare. 


CHAPTER  IX 
VITAMINES 

"IT  has  thus  far  been  shown  that  nutrition  means 
fuel  for  the  machinery,  new  parts  with  which  to  repair 
the  machine,  and  minute  quantities  of  '  vitamines '  which 
produce  a  harmonious  interaction  between  the  materials 
in  the  food  and  their  host."  —  Lusk. 

Ferments  of  Life 

"Vitamines  are  ferments  of  life,  substances  without 
which  a  food  does  not  keep  one  healthy,  even  though  on 
a  balanced  ration."  —  Evans. 

Funk  says :  "  Vitamines  are  mother  substances  of  di- 
gestive ferments  and  of  body  hormones  as  thyroid  secre- 
tion and  other  internal  secretions.  Food  may  be  ever  so 
nourishing,  but  if  without  vitamines,  the  body  cannot 
construct  its  own  ferments  and  carry  on  its  own  vital 
activities." 

The  word  "  vitamine "  is  no  longer  new,  and  is  so 
commonly  used  that  nearly  every  one  at  all  interested  in 
foods  has  an  idea  of  its  meaning.  We  have  already  used 
it  with  little  explanation  and  believe  that  few  are  in  the 
dark  as  to  its  significance.  However,  its  interest  and 
importance  is  such  that  a  little  time  spent  in  a  more 
detailed  study  of  these  vital  elements  would  seem  quite 
worth  while,  if  not  necessary. 

Beriberi 

Years  were  spent  in  investigation  before  it  was  found 
that  beriberi,  a  disease  of  the  Orient,  could  be  cured  and 
prevented  by  the  addition  to  the  diet  of  the  nutritive 
elements  ordinarily  thrown  away  in  the  polishings  of 
rice.  Just  what  these  nutritive  elements  were  was  not 


70  THE    HOME   DIETITIAN 

understood,  but  the  fact  remained  that  a  diet  of  polished 
rice  resulted  in  symptoms  of  beriberi,  while  a  diet  of  the 
unpolished  grain  was  sufficient  to  prevent  any  manifesta- 
tion of  the  disease.  In  Java,  where  the  people  lived 
largely  on  whole  rice,  beriberi  was  unknown. 

Scurvy 

For  years  it  has  been  a  recognized  fact  that  sailors 
living  on  canned  and  preserved  foods  sooner  or  later 
contract  scurvy,  but  that  this  disease  is  speedily  cured 
by  the  addition  to  their  diet  of  fresh  vegetables  or  the 
juices  of  fruits,  especially  the  orange  and  the  lemon.  In 
1535,  when  all  but  three  of  Cartier's  110  sailors  had 
scurvy,  he  cured  them  all  by  giving  them  a  decoction  of 
fresh  pine  needles. 

Babies  fed  on  Pasteurized  milk  often  contract  infan- 
tile scurvy,  but  may  be  cured  in  a  remarkably  short 
time  by  the  addition  of  orange  juice  to  their  diet.  Po- 
tato water  and  other  vegetable  broths  may  be  given 
these  babies  with  the  same  beneficial  effect,  the  symp- 
toms of  scurvy  rapidly  disappearing.  When  fed  on  oats 
or  barley  only,  guinea  pigs  die  from  scurvy,  but  if  the 
grain  is  moistened  and  allowed  to  sprout,  which  prac- 
tically converts  the  grain  into  fresh  vegetables,  the  dis- 
ease is  prevented. 

Pellagra 

Pellagra,  a  disease  of  the  Southern  States,  manifests 
itself  largely  among  a  class  of  people  living  on  a  monot- 
onous diet  of  corn  bread,  bacon,  biscuit,  and  sirup. 
Goldberger's  experiments  in  the  State  penitentiary  in 
Mississippi,  showed  that  many  cases  of  pellagra  resulted 
when  the  inmates  were  kept  upon  a  diet  of  white  flour, 
grits,  cornmeal,  fried  mush,  brown  gravy,  sweet  po- 
tatoes, coffee  with  sugar,  and  sirup.  The  introduction 
of  oatmeal  and  fresh  vegetables  practically  eliminated 
the  pellagra. 


VITAMINES  71 

A  Restricted  Diet 

"  The  regular  diet  of  thousands  of  the  poor  people  of 
the  Southern  States  during  the  winter  contains  little  be- 
s'des  corn  bread,  molasses,  and  a  small  amount  of  salt 
pork.  After  three  or  four  months  of  such  a  diet,  large 
numbers  of  them  develop  pellagra.  That  the  cornmeal 
which  is  eaten  has  in  itself  nothing  to  do  with  the  pro- 
duction of  pellagra  is  evident  from  the  fact  that  the  dis- 
ease occurs  with  those  who  have  not  eaten  corn  products 
in  the  period  preceding  the  attack.  Corn  rightly  used 
is  a  wholesome  foodstuff,  and  there  is  no  warrant  for 
the  belief  sometimes  expressed  that  it  is  the  cause  of 
pellagra.  It  is  the  restricted  character  of  the  diet, 
which  is  undoubtedly  rendered  unsatisfactory  by  several 
factors  operating  simultaneously,  not  corn  or  any  other 
single  food,  which  causes  the  disease.  When  the  char- 
acter of  the  diet  is  improved  by  doing  away  with  an  ex- 
cess of  alkali  (baking  soda)  in  cookery  and  by  the  in- 
troduction of  a  wider  range  of  foods,  .  .  .  many  of 
the  milder  cases  of  the  disease  recover."  - "  Ten  Les- 
sons of  Food  Conservation,"  U.  S.  Food  Administration, 
pp.  50,  51. 

Deficiency   Diseases 

No  matter  how  plentiful  in  "  calories  "  the  diet  is,  it 
became  apparent  that  there  might  be  a  deficiency  else- 
where with  disastrous  results  to  the  body,  hence  the 
term  "  deficiency  disease."  Unmistakably  beriberi  and 
scurvy  come  under  this  head,  and  the  above  observations 
strongly  suggest  that  pellagra  is  also  a  deficiency  dis- 
ease. There  are  some  investigators  who  believe  that  a 
predisposition,  at  least,  to  rickets  in  children,  to  eczema, 
and  even  to  such  infections  as  tuberculosis  and  pyorrhea, 
may  result  from  a  diet  deficient  in  certain  vital  ele- 
ments. 


72  THE    HOME   DIETITIAN 

Pyorrhea 

Dr.  A.  S.  Gray  says  that  pyorrhea  is  the  "  result  of 
lowered  vitality  from  lack  of  those  organic  compounds 
other  than  the  proteins  which  Casimir  Funk  and  other 
investigators  prove  to  be  present  in  fresh  vegetables  and 
in  lime  and  other  fruit  juices,  small  quantities  of  which 
are  absolutely  essential  to  growth  and  health."  Gray 
also  says :  "  A  diet  largely  composed  of  sterilized  milk, 
corn  flours,  starch,  and  sugar,  or  of  any  foods  subjected 
for  a  long  period  to  a  temperature  above  250°,  may  be 
considered  vitamineless  and  will  predispose  to  tubercu- 
losis, beriberi,  pellagra,  rickets,  scurvy,  osteomalacia, 
etc." 

A  Vital  Substance 

Casimir  Funk,  working  along  this  line,  perfected 
some  experiments  that  resulted  in  added  light  being 
thrown  upon  this  most  interesting  subject.  He  was 
able  to  produce  experimental  beriberi  in  pigeons  by  feed- 
ing them  for  three  weeks  on  polished  rice.  Then  if  they 
were  fed  the  polishings  from  this  same  rice  they  were 
cured  of  their  symptoms  in  a  remarkably  short  time, 
showing  that  in  the  rice  polishings  were  certain  ele- 
ments absolutely  essential  to  life.  What  could  this  vital 
substance  be? 

A  Rapid  Cure 

By  a  series  of  experiments  he  finally  isolated  from  the 
rice  polishings  a  minute  crystalline  substance,  of  which 
two  pounds  of  rice  polishings  yielded  about  one  half  a 
grain.  Injecting  under  the  skin  or  into  the  crop  of  a 
dying  pigeon  three  tenths  of  a  grain  of  this  crystalline 
material  was  sufficient  not  only  to  make  it  well  in  a 
few  hours,  but  also  to  keep  it  so  for  two  weeks  while 
on  a  diet  of  polished  rice, 


VITAMINES  73 

Vitamine 

This  precious  crystalline  substance,  which  contained 
nitrogen,  Funk  called  vitamine  from  "  vita,"  meaning 
life,  and  from  "  amine,"  a  nitrogenous  chemical  com- 
pound closely  related  to  the  proteins. 

Besides  this  vitamine  which  so  remarkably  prevented 
beriberi  and  which  Funk  called  the  beriberi  vitamine,  he 
also  isolated  a  vitamine  seemingly  having  an  especial  ac- 
tion in  the  prevention  of  scurvy,  or  the  scurvy  vitamine. 

Three  Important  Vitamines 

Moreover,  experiments  by  Dr.  McCollum  and  others 
have  shown  that  animals  do  not  grow  and  develop  prop- 
erly unless,  to  a  ciet  which  furnishes  simply  calories  of 
protein,  fat,  and  carbohydrate,  there  is  added  other  food 
such  as  butter  fat,  egg  yolk,  or  green  leaves.  These 
furnish  an  indefinite  something  which  induces  proper 
use  of  the  caloric  intake  with  normal  growth  and  devel- 
opment. There  seems  to  be  a  definite  vitamine,  in  addi- 
tion to  the  beriberi  and  scurvy  vitamines,  which  has  an 
especial  action  in  inducing  proper  growth.  The  first  two 
seem  to  have  to  do  with  the  maintenance  of  the  body 
in  health ;  the  last  with  the  building  of  new  tissue.  The 
first  two  are  soluble  in  water  and  are  designated  respec- 
tively water-soluble  B  and  water-soluble  C.  The  growth- 
producing  vitamine  is  soluble  only  in  fat  and  is  called 
fat-soluble  A.  While  all  need  water-soluble  B  and  C, 
children  particularly  require  fat-soluble  A. 

If  Fat-Soluble  A  Lacking 

Young  rats,  deprived  for  a  few  weeks  of  the  fat- 
soluble  A,  develop  a  severe  inflammatory  condition  of 
the  eye,  which  destroys  the  sight  unless  this  vitamine 
is  added  to  the  diet,  whereupon  the  eye  condition  returns 
to  normal.  Eye  conditions  analogous  to  this  have  been 


74  THE    HOME   DIETITIAN 

found  in  warring  countries  where  children  have  been 
for  some  time  on  a  diet  devoid  of  this  vitamine.  Many 
consider  that  rickets  is  due  to  a  deficiency  of  the  fat- 
soluble  vitamine,  together  with  some  disturbance  in  the 
calcium-phosphorus  metabolism. 

All  Body  Organs  Affected 

Since  a  sufficient  lack  of  any  particular  vitamine  will 
produce  symptoms  of  some  definite  disease,  as  scurvy,  it 
is  reasonable  to  suppose  that  a  lesser  deficiency,  even 
though  slight,  in  one  or  more  vitamines  may  bring  on 
varying  conditions  of  lowered  vitality  and  poor  nutri- 
tion not  attributable  to  any  disease,  and  the  cause  often 
be  unrecognized. 

The  following  from  Dr.  W.  H.  Wilcox,  in  the  British 
Medical  Journal,  July  31,  1920,  is  of  interest: 

"  The  extremely  interesting  and  important  researches 
of  Lieut.  Col.  R.  McCarrison  have  shed  quite  a  new 
light  on  the  influence  of  vitamines  in  nutrition,  and  our 
conception  of  the  action  of  these  accessory  food  factors 
has  become  greatly  enlarged  in  consequence.  It  appears 
that  vitamines  have  a  wide-reaching  influence  on  all 
the  organs  of  the  body,  and  that  the  functions  of  the 
endocrine  glands,  of  the  gastro-intestinal  tract,  the 
heart  and  nervous  system,  etc.,  are  powerfully  affected. 
Absence  of  vitamines  in  the  dietary  of  an  animal  causes 
marked  changes  in  practically  all  the  bodily  organs; 
thus  colitis,  enterocolitis  may  be  early  symptoms,  and 
marked  changes  may  occur  in  the  suprarenal  glands; 
for  example,  if  the  dietary  is  deficient  in  antiscorbutic 
or  antiberiberi  vitamines. 

"  It  seems  certain  that  these  views  are  applicable  to 
clinical  medicine  in  man.  In  cases  of  malnutrition, 
whether  due  to  a  defective  diet  or  to  some  chronic  dis- 
ease, such  as  sprue,  chronic  colitis,  dysentery,  etc.,  it  is 


VITAMINES  75 

most  important  that  the  dietary  should  be  ...  espe- 
cially selected  from  the  point  of  view  of  high  vitamine 
value.  ...  It  must  be  remembered  that  vitamines  have 
not  only  important  action  on  the  general  nutrition  of 
the  body,  but  they  also  have  a  reaction  on  the  func- 
tions of  the  important  secretory  glands ;  and  when  these 
functions  are  impaired,  ...  a  diet  rich  in  vitamines 
will  have  a  markedly  beneficial  effect  in  stimulating  the 
repair  of  the  damaged  organs  and  their  impaired  func- 
tions." 

A  Battery 

Much  has  yet  to  be  learned  in  regard  to  these  life- 
giving  substances,  and  whether  or  not  they  are  "  amines  " 
is  still  a  debated  question,  but  the  experiments  by  Funk 
and  other  investigators  have  given  evidence  quite  suffi- 
cient to  help  us  materially  in  planning  a  diet  that  will 
completely  supply  the  body  needs.  In  addition  to  a  suf- 
ficient diet  as  regards  the  caloric  value  of  our  food,  it 
is  quite  as  important  that  daily  we  obtain  in  some  way 
an  adequate  amount  of  vitamine,  the  battery,  as  it  were, 
which  keeps  in  operation  the  vital  processes  of  the  body, 
and  makes  possible  a  utilization  by  the  body  of  food 
materials. 

Vitamines  as  Related  to  Protein 

Just  what  may  be  the  relation  of  vitamines  to  the  pro- 
teins is  as  yet  not  fully  determined.  Funk  called  atten- 
tion to  the  fact  that  on  a  diet  composed  largely  of  car- 
bohydrates, more  vitamines  seemed  to  be  needed  by  the 
body  than  when  a  large  amount  of  protein  is  taken. 
This  is  undoubtedly  due  in  part  at  least  to  the  fact  that 
much  of  the  carbohydrate  is  taken  separated  from  its 
natural  setting  (see  Chapter  VIII),  without  its  vitamines 
and  salts.  Protein  foods,  however,  are  more  often  com- 
bined with  vital  food  accessories.  At  any  rate,  though 


76  THE    HOME   DIETITIAN 

all  need  an  ample  supply  of  vitamine  food,  yet  the  vege- 
tarian and  the  one  living  on  a  low-protein  ration  seem 
to  need  even  more  an  abundant  supply  of  these  ferments 
of  life.  It  has  been  suggested  that  the  protein  with  its 
nitrogen  content  can  to  an  extent  take  the  place  of  the 
vitamine  when  this  is  for  any  reason  deficient,  and  that, 
vice  versa,  the  vitamine  can  supplement  a  deficiency  of 
protein.  It  seems  that  an  individual  on  a  diet  contain- 
ing a  large  amount  of  vitamines  can  do  well  on  a  much 
lower  protein  diet  than  one  in  whose  daily  ration  the 
vitamine  content  is  low. 

It  is  a  fact  not  without  significance  that  many  foods 
containing  vitamines,  e.  g.,  the  leafy  vegetables,  contain 
also  a  definite  amount  of  protein  of  a  most  excellent 
quality  as  well  as  a  good  supply  of  mineral  salts.  Just 
where  conditions  apparently  due  to  a  lack  of  vitamines 
may  be  combined  with,  and  overlap,  symptoms  referable 
to  a  deficiency  in  mineral  salts  and  complete  proteins, 
is  a  debatable  question.  The  experimental  investiga- 
tions conducted  have  quite  conclusively  shown,  however, 
that  the  supplying  of  missing  protein  links  x  and  refined 
mineral  salts  is  not  sufficient  for  normal  body  mainte- 
nance and  development  unless,  with  these,  are  furnished 
the  vital  elements  as  classified  above. 

Foods  That  Are  Alive 

What  foods,  then,  contain  vitamines?  This  is  the 
practical  question.  All  raw  foods  contain  them,  as  raw 


1  By  "  links  "  is  meant  the  amino  acids  which  are  united  to  form  proteins. 
Proteins  are  very  complex  compounds  consisting  of  many  simpler  compounds 
(amino  acids)  linked  together.  There  are  some  eighteen  of  these  amino  acids. 
Some  proteins  lack  one  or  more  of  the  amino  acids,  and  so  are  not  complete  pro- 
teins. When  proteins  are  digested,  they  are  broken  up  into  their  separate  amino 
acids.  These  are  absorbed  into  the  blood  and  are  there  built  up  into  such  proteins 
as  the  body  needs.  If  any  of  the  necessary  amino  acids  are  lacking,  the  body  can- 
not build  its  proteins.  The  proteins  of  all  seeds  (grains,  legumes,  nuts)  seem  to  be 
lacking  in  certain  of  the  amino  acids.  But  the  proteins  of  the  leaves  of  plants 
and  the  proteins  of  milk  contain  these  missing  amino  acids,  and  when  used  in 
sufficient  quantity,  they  serve  to  make  up  the  deficiency  of  the  seed  proteins.  For 
this  reason  the  cereals  (including  bread)  should  be  eaten  in  connection  with  either 
green  vegetables  or  milk,  or  both.  Meat  will  also  make  up  the  deficiency,  but  for 
reasons  explained  elsewhere  we  do  not  advise  its  use. 


VITAMINES  77 

fruit,  raw  vegetables,  raw  milk,  raw  meat ;  also  all  fresh 
vegetables  properly  prepared  and  not  overcooked.  The 
leafy  vegetables  are  very  rich  in  all  vitamines.2  Young 
carrots  have  been  found  to  be  rich  in  all  classes  of  vita- 
mines.  All  whole  cereals,  raw  or  cooked  at  not  too  high 
a  temperature,  as  in  a  double  boiler  or,  better  still,  in  a 
fireless  cooker,  contain  vitamines.  Vitamines  are  pres- 
ent in  the  outer  layer  and  in  the  germ  of  grain,  and  they 
are  abundant  just  under  the  skin  of  vegetables  and  in 
fruits.  They  are  also  present  in  brewer's  yeast. 

Water-soluble  B  and  water-soluble  C  vitamines  are 
rather  more  widely  distributed  than  the  fat-soluble  A. 
This  last  is  found  in  foods  containing  fat.  As  it  has  to 
do  with  development  of  the  young,  it  is  abundant  in  all 
animal  foods  intended  by  nature  to  nourish  the  young, 
as  the  fat  of  milk,  the  yolk  of  the  egg.  It  is  found  in 
glandular  tissues  of  the  animal  body,  the  cells  of  which 
are  continually  reproducing  themselves,  as  in  the  liver. 
Therefore  a  reason  for  its  abundance  in  cod-liver  oil, 
long  considered  almost  a  specific  in  many  nutritional 
diseases  of  childhood.  However,  it  is  possible  to  obtain 
it  directly  from  plant  foods.  It  is  found  in  the  germ  of 
grain  and  in  leafy  vegetables,  in  young  carrots,  to- 
matoes, and  even  in  orange  juice.  These  all  contain 
enough  fat  to  hold  in  solution  necessary  amounts  of  this 


2  The  following  is  quoted  from  Dr.  Graham  Lusk  as  given  in  an  address  at  the 
Auditorium,  National  Museum,  Washington,  D.  C.,  Aug.  30,  1917 :  "  Two  Italian 
scientists  describe  how  this  class  of  people  (Italian  peasants)  live  mainly  on  corn- 
meal,  olive  oil,  and  green  stuffs,  and  have  done  so  for  generations.  There  is  no 
milk,  cheese,  or  eggs  in  their  dietary.  Meat  in  the  form  of  fat  pork  is  taken  three 
or  four  times  a  year.  .  .  .  Little  wonder  that  such  people  have  migrated  to 
America,  but  it  may  strike  some  as  astonishing  that  a  race  so  nourished  should 
have  become  the  man  power  in  the  construction  of  our  railways,  our  subways,  and 
our  great  buildings. 

"  Dr.  McCollum  will  tell  you  that  the  secret  of  it  all  lies  in  the  green  leaves. 
The  quality  of  the  protein  in  corn  is  poor,  but  the  protein  in  the  leaves  supple- 
ments that  of  corn,  so  that  good  result  is  obtained.  Olive  oil  when  taken  alone  is 
a  poor  fat  in  a  nutritive  sense,  but  when  taken  with  green  leaves,  these  furnish 
one  of  the  peculiar  accessory  substances,  commonly  known  as  vitamines,  which  is 
present  most  abundantly  in  butter  fat,  and  gives  to  butter  fat  and  to  the  fat  in 
the  whole  milk  its  dominant  nutritive  value.  The  green  leaves  also  furnish  another 
accessory  substance  which  is  soluble  in  water  and  which  is  necessary  for  normal 
life.  Furthermore,  the  green  leaves  contain  mineral  matter  in  considerable  quan- 
tity and  in  about  the  same  proportions  as  they  exist  in  milk." 


78  THE    HOME   DIETITIAN 

important  substance,  and,  for  this  reason,  are  invaluable 
as  aids  in  the  feeding  of  children.  Foods  containing  the 
fat-soluble  A  invariably  contain  the  other  vitamines  as 
well. 

Foods  That  Are  Dead 

Vitamines  may  be  destroyed  by  overheating  or  dry- 
ing, or  may  be  removed  from  the  food  in  the  process  of 
preparation.  Dried,  preserved,  and  commercially  canned 
foods  are  generally  vitamineless,  an  exception  to  this 
being  the  canned  tomato,  the  acid  of  which  seems  to 
stabilize  its  vitamine.  In  all  processed  grains,  as  white 
flour  and  polished  rice,  the  vitamines  have  been  removed. 
The  vitamines  remain  in  the  outer,  coarser  portion  and 
are  often  fed  to  stock,  which  thrive  on  "  shorts,"  the 
pait  of  the  grain  discarded  by  the  human  animal.  All 
refined  foods  are  vitamineless,  as,  e.  g.,  cane  sugar,  re- 
fined oils,  etc.  It  is  said  that  pellagra,  which  is  on  the 
increase  in  America,  is  more  acute  and  fatal  here  than 
elsewhere  because  of  the  superior  machinery  used  in  the 
processing  of  food.  "  Food  is  too  much  refined,  too  much 
polished,  too  much  cooked,  too  much  dried/' 

Just  how  much  ordinary  home  cooking  destroys  the 
vitamines  is  a  question,  and  no  doubt  varies  greatly. 
(See  page  107.) 

Some  Vitamines  More  Stable 

In  the  paring  of  vegetables  many  vitamines  are  lost; 
in  the  boiling,  most  of  those  remaining  pass  into  the 
water,  which  is  usually  thrown  away.  Vitamines  are 
destroyed  by  baking  powder  and  soda,  a  strong  argu- 
ment against  the  use  of  these  powders  in  the  cooking  of 
vegetables  and  the  baking  of  bread.  Vitamines  are 
more  stable  in  some  foods  than  in  others;  e.  g.,  rasp- 
berry juice  can  be  boiled  one  hour  without  losing  its 
vitality,  while  lemon  or  lime  juice  can  be  boiled  and  kept 


VITAMINES  79 

indefinitely  without  becoming  devitalized.  As  has  been 
said,  tomatoes,  even  though  canned,  retain  their  vita- 
mines  indefinitely. 

A  Danger 

Individuals  with  weak  digestive  organs,  unable  to  di- 
gest bulky  food,  are  often  in  danger  of  living  on  a  vita- 
mineless  diet  because  their  vegetables  are  pureed,  their 
cereals  are  processed,  often  in  the  form  of  gruels  with 
the  coarser  particles  removed,  or  much  of  their  food  is 
dextrinized,  superheated,  their  bread  twice  baked,  and 
fruits  perhaps  eliminated  entirely  from  their  diet.  But 
plans  should  be  laid  for  these  persons  as  well  as  for  all 
others,  that  in  their  daily  ration  may  be  supplied  these 
vital  substances  upon  which  the  body  is  so  dependent. 
For  these  persons  it  should  be  remembered  that  broths 
prepared  from  vegetables  without  removing  the  skins, 
are  very  rich  in  vitamines. 

A  Safe  Course 

Our  safety  then  lies  in  keeping  close  to  nature,  in  eat- 
ing freely  of  fresh  fruits  and  leaf  vegetables,3  raw  vege- 
tables plain  and  in  salads,  in  saving  and  using  vegetable 
broths,  in  replacing  fine,  white  flour  bread  with  whole- 
wheat and  Graham  bread,  in  the  eating  of  grains  still 


3  The  dietetic  value  of  the  leaves  of  plants  (leaf  vegetables)  as  compared  with 
that  of  the  seeds  (grains  and  legumes)  has  been  conclusively  shown  by  the  experi- 
ments of  McCollum.  Simmonds.  and  Pitz.  The  seed  of  the  plant  is  its  storehouse, 
and  aside  from  the  germ,  contains  no  living  matter.  The  seed,  while  rich  in  caloric 
food  value,  has  a  protein  of  relatively  poor  quality ;  it  is  low  in  inorganic  salts  and 
is  deficient  in  the  fat-soluble  vitamine.  The  leaf  of  the  plant  is  made  up  largely 
of  living  cells.  It  is  the  active  respiring  portion,  the  laboratory  of  the  plant 
where  starches,  fats,  and  proteins  are  built  up.  This  part  of  the  plant  supple- 
ments the  nutritive  shortcomings  of  the  seed.  We  quote  from  McCollum :  "  From 
the  results  of  experiments  just  described  it  was  necessary  to  conclude  that  the  leaf 
differs  from  the  seed  in  that  it  contains  in  satisfactory  amounts  the  dietary  factors 
which  are  found  in  the  seeds  in  too  small  amounts.  These  include  the  three  in- 
organic elements,  calcium,  sodium,  and  chlorine,  the  fat-soluble  A.  and  a  protein 
supply  which  supplements,  at  least  in  some  degree,  the  proteins  of  the  seed.  These, 
it  will  be  remembered,  are  the  three  and  only  purified  food  factors  which  need  to 
be  added  to  each  of  the  seeds  singly  in  order  to  make  it  dietetically  complete.  It  is 
therefore  possible  to  devise  a  diet  which  is  derived  entirely  from  vegetable  materials 
which  will  produce  normal  growth  and  the  optimum  physiological  well-being."  — 
"  The  Newer  Knowledge  of  Nutrition,"  p.  64. 


80  THE    HOME   DIETITIAN 

retaining  all  their  food  elements,  as  brown  4  rice,  oat- 
meal, whole  wheat,  and  unbolted  cornmeal,  and  withal 
to  vary  the  diet,  avoiding  a  monotony  in  the  food 
supply. 

For  the  Children 

Especially  should  these  things  be  borne  in  mind  in 
the  feeding  of  children.  The  importance  of  this  cannot 
be  overestimated.  Children  must  have  a  varied  diet  of 
whole  cereals,  fruits,  and  a  liberal  supply  of  green  vege- 
tables and  vegetable  broths.  These  with  milk  will  in 
most  cases  supply  their  dietetic  needs,  with  an  abun- 
dance of  the  fat-soluble  vitamine  as  well.  (See  Chapter 
XXI.) 

Do  Not  Starve  While  Feasting 

Many  things  contain  vitamines,  and  while  some  of  the 
foods  in  our  daily  ration  may  necessarily  be  devoid  of 
them,  with  a  little  careful  planning  it  will  be  found  a 
very  easy  matter  to  add  a  sufficient  quantity  of  foods 
rich  in  vitamines  that  the  supply  may  be  a  liberal  one. 
We  need  food  for  calories  and  for  vitamines  as  well,  and 
it  is  important  that  we  remember  the  danger  of  "  starv- 
ing while  feasting."  Obedience  to  all  other  laws  of  hy- 
giene and  dietetics  will  avail  one  but  little  if  one  lives 
continually  on  a  devitalized  diet. 

We  quote  again  from  Dr.  A.  S.  Gray :  "  The  wise  man 
takes  no  chances  and  simply  sticks  close  to  nature. 
This  means  eating  simple,  properly  prepared,  unproc- 
essed foods." 


4  The  rice  grain  as  it  comes  from  the  threshing  machine,  is  incased  in  a  husk, 
or  hull,  very  much  like  barley.  It  is  then  known  as  "  paddy."  When  the  husk  has 
been  removed,  it  is  called  "  pearled  rice,"  or  "  brown  rice,"  because  of  the  brown 
gluten  coating  found  just  under  the  husk.  The  next  milling  process  removes  this 
brown  coat,  when  the  grain  becomes  "  milled  rice,"  which  is  then  separated  into 
various  grades ;  the  finest  grain,  being  given  a  coating  of  glucose  and  talc,  is 
then  known  as  "  polished  rice."  Brown  rice  as  used  here  should  not  be  confused  with 
"  browned  "  rice,  as  used  on  pages  115,  237,  294. 


CHAPTER  X 
MINERAL  SALTS 

A  VERY  important  part  of  the  body  structure  is  the 
mineral  matter  that  enters  into  it.  The  ash  of  the  body 
consists  of  chlorides,  phosphates,  sulphates,  carbonates, 
fluorides,  and  silicates  of  potassium,  sodium,  calcium, 
magnesium,  and  iron.  Iodine  occurs  also  in  the  thyroid 
gland.  In  the  body  fluids,  the  principal  organic  salts 
are  sodium  chloride,  sodium  carbonate,  and  sodium 
bicarbonate,  sodium  phosphate,  potassium  chloride,  po- 
tassium sulphate,  calcium  chloride,  and  calcium  phos- 
phate. 

Everyday    Names 

Some  of  these  chemical  elements  are  known  by  more 
common  names,  as  potash  for  potassium,  soda  for  so- 
dium, lime  for  calcium,  and  magnesia  for  magnesium. 
In  common  phraseology  we  hear  of  carbonate  of  potash 
instead  of  potassium  carbonate;  of  phosphate  of  lime  in- 
stead of  calcium  phosphate.  It  is  interesting  to  know 
that  the  term  "  potassium  carbonate  "  is  but  the  chemical 
name  for  lye,  as  "  calcium  carbonate  "  is  for  chalk,  lime- 
stone, and  marble;  that  sodium  chloride  is  our  familiar 
table  salt;  sodium  bicarbonate  but  another  name  for 
baking  soda,  and  sodium  carbonate  synonymous  with 
washing  soda. 

Functions   Many   and   Varied 

Lime  salts  in  the  form  of  calcium  phosphate  make  up 
the  principal  part  of  the  bones  and  teeth.  Mineral  salts 
enter  into  the  composition  of  the  blood  and  are  found  in 
all  secretions  and  excretions.  It  is  the  presence  of  min- 

6  81 


82  THE    HOME    DIETITIAN 

eral  salts  in  right  proportion  that  maintains  the  proper 
chemical  reaction  of  all  body  fluids  and  secretions;  that 
keeps  the  blood  alkaline,  the  gastric  juice  acid.  It  is  the 
presence  of  mineral  salts  that  maintains  conditions  o 
normal  osmotic  pressure,  a  proper  rate  of  absorption  in 
the  digestive  tract,  and  necessary  interchange  of  all  body 
fluids.  The  normal  solvent  power  of  the  blood  is  also 
made  possible  by  the  presence  of  these  inorganic  ele- 
ments. 

Calcium  salts  are  not  only  found  in  the  bones  and 
teeth,  but  are  an  important  constituent  of  the  blood  it- 
self, where  their  presence  helps  to  regulate  the  power  of 
the  blood  to  coagulate  properly.  Calcium  salts  are  es- 
sential to  all  cellular  growth  and  development,  and  are 
an  important  factor  in  governing  the  normal  contractil- 
ity of  muscle. 

Magnesium  salts  occur  largely  in  the  skeleton,  but 
also  in  the  soft  tissues  and  fluids  of  the  body. 

Iron  is  an  essential  element  of  the  hemoglobin  of  the 
red  blood  cells,  and  thus  plays  an  important  part  in  the 
body  processes  of  oxidation,  secretion,  and  development. 
It  is  well  known  that  iron  is  necessary  for  red  blood; 
hence  the  popularity  of  the  "  iron  tonic." 

Phosphorus,  as  phosphates  of  potassium  and  calcium, 
enters  into  the  structure  of  all  body  cells  and  is  espe- 
cially abundant  in  the  bones  and  in  the  central  nervous 
system.  In  combination  with  sodium  as  disodium  phos- 
phate, it  aids  in  maintaining  the  normal  alkalinity  of 
the  blood.  (See  page  85.) 

Sulphur  enters  the  body  as  a  part  of  the  protein  mole- 
cule, and  is  the  source  of  the  sulphuric  acid  formed  when 
the  protein  molecule  is  broken  down.  (See  page  85.) 

Sodium,  in  combination  with  chlorine  as  sodium  chlo- 
ride, forms  60  per  cent  of  the  salts  of  the  blood,  and 
enters  into  the  structure  of  all  the  tissues  and  secretions 


MINERAL    SALTS  83 

of  the  body  in  greater  or  less  degree.  In  the  form  of  the 
bicarbonate,  sodium  plays  an  important  part  in  the 
maintenance  of  normal  blood  reaction. 

While  sodium  salts  predominate  in  body  fluids,  the 
cellular  and  soft  solid  tissues  are  especially  rich  in  salts 
of  potassium.  Potassium  chloride  is  an  important  salt 
of  muscle  tissue. 

Chlorine  is  found  in  the  body  principally  as  the  chlo- 
rides of  sodium  and  potassium. 

The  contractility  of  muscle  is  affected  not  only  by 
calcium  salts,  but  also  by  the  salts  of  sodium  and  potas- 
sium. It  is  necessary  that  the  blood  contain  all  these 
salts  in  proper  proportion,  in  order  that  there  may  be 
the  right  relationship  between  muscular  contraction  and 
relaxation.  The  three  remaining  chemical  elements  men- 
tioned in  Chapter  I,  and  not  already  discussed,  are  pres- 
ent in  the  body  in  very  minute  quantities. 

No  one  mineral  salt  is  limited  to  any  certain  class  of 
body  structures  (unless  it  be  the  iodine  of  the  thyroid 
gland),  but  all  take  part  in  a  greater  or  less  degree  in 
the  formation  of  all  tissue,  so  the  entire  body  suffers 
when  there  is  a  lack  of  any  particular  element. 

If  Mineral   Elements  Are  Lacking 

It  is  q'uite  evident,  then,  why  the  food  ration  should 
include  a  goodly  amount  of  mineral  matter.  The  bones 
and  teeth  of  a  child  soon  suffer  from  a  lack  of  lime 
salts  in  the  food.  An  incomplete  supply  to  the  bony 
structures  of  calcium  and  phosphorus  in  proper  propor- 
tions is  undoubtedly  a  factor  in  the  causation  of  rickets. 
The  blood  soon  shows  the  effect  of  a  lack  of  iron.  Cel- 
lular tissues,  particularly,  suffer  from  a  lack  of  phos- 
phorus, sulphur,  and  potassium;  the  blood  and  secretive 
processes  from  an  incomplete  supply  of  sodium  and 
chlorine. 


84  THE    HOME   DIETITIAN 

Salts  —  Neutral,   Acid,  or  Alkaline 

Perhaps  the  most  important  phase  of  the  relation  of 
mineral  salts  to  the  conduct  of  the  body  functions  is  in 
the  maintenance  of  a  normal  degree  of  blood  alkalinity. 
It  is  well  known  that  acids  are  sour,  as,  for  example, 
hydrochloric  acid,  citric  acid,  acetic  acid;  that  alkalies 
are  soapy,  caustic,  as  caustic  potash,  soap,  lye.  Acids 
and  alkalies  in  the  right  proportion  neutralize  each 
other  and  form  harmless  neutral  salts.  Every  salt  is 
a  combination  of  an  acid  with  an  alkaline  element. 
Alkalies  are  also  spoken  of  as  basic  elements  or  bases. 
If  the  basic  element  predominates,  or  is  stronger,  an 
alkaline  salt  is  the  result.  If  the  acid  element  is  greater, 
the  result  is  an  acid  salt.  So  in  addition  to  neutral 
salts  we  have  alkaline  salts  and  acid  salts.  Sodium  car- 
bonate (washing  soda)  and  sodium  bicarbonate  (baking 
soda)  are  alkaline  salts.  The  one  is  more  alkaline  than 
the  other  because  it  contains  twice  as  much  of  the  strong 
basic  substance,  sodium.  The  acids  of  fruits  are  in  the 
form  of  acid  salts  —  that  is,  salts  containing  less  of  the 
basic  than  of  the  acid  element;  for  example,  sodium 
acid  citrate  of  citrous  fruits. 

Alkalinity,  Life  —  Acidity,  Death 

It  is  not  quite  so  commonly  known,  however,  that  it 
is  necessary  for  animal  life  that  the  body  cells  be  con- 
tinually bathed  in  a  mildly  alkaline  fluid.  Thus,  we  find 
the  blood  maintaining  a  degree  of  alkalinity  equal  to  a 
definite  proportion  of  sodium  bicarbonate.  In  fact,  it 
is  the  presence  of  sodium  bicarbonate  itself  in  the  blood 
that  maintains  this  constant  reaction.  In  the  animal 
body  waste,  decomposition  and  death  ever  result  in  acid 
formation.  Constructive  processes,  repair,  and  life 
mean  a  preponderance  of  alkalinity.  Balance  in  favor 
of  alkalinity  means  life;  in  favor  of  acid  means  death. 


MINERAL    SALTS  85 

How  Acids  Are  Formed 

Acids  are  formed  in  the  body  in  various  ways.  They 
are  formed  in  a  greater  or  less  degree  from  all  body 
wastes.  As  already  suggested,  they  result  from  de- 
composition in  the  digestive  tract,  and  oxidation  proc- 
esses in  the  tissues.  Muscular  contraction  results  in  the 
formation  of  iso-lactic  acid.  Interference  with  oxidation 
or  elimination  increases  the  acid  content  of  the  blood. 

But  the  greater  part  of  the  acid  is  produced  in  con- 
nection with  the  metabolism  of  protein.  This  acid  is  in 
the  form  of  sulphuric  acid.  Eighty  per  cent  of  the  sul- 
phur taken  in  as  part  of  the  protein  is  converted  into 
this  acid.  This  must  at  once  be  neutralized,  for  sul- 
phuric acid  even  in  small  concentration  would  be  very 
injurious  to  the  cells. 

How  Neutralized 

The  exact  chemistry  of  neutralization  is  not  fully  un- 
derstood, but  for  those  interested  in  chemistry,  we  give 
the  following  as  illustrative  of  what  probably  occurs. 
Alkaline  carbonates,  e.  g.,  sodium  carbonate,  react  with 
the  sulphuric  acid,  giving  as  a  result  sodium  sulphate 
and  carbonic  acid  (H2S04+Na2CO,=Na2S04+H2CO3). 
The  strong  base,  sodium,  uniting  with  the  strong  acid, 
sulphuric,  is  neutralized,  and  the  weak  acid,  carbonic, 
is  formed  from  the  slight  acid  excess.  The  resulting 
carbonic  acid,  carried  to  the  lungs,  is  eliminated  as 
carbon  dioxide  (C02). 

The  blood  also  contains  disodium  phosphate,  a  salt  of 
phosphoric  acid,  and  alkaline,  because  it  contains  a  large 
amount  of  the  base,  sodium.  This  reacts  with  the  sul- 
phuric acid  (2Na2HP04+H2S04r=Na2S04+2NaH2PO4), 
and,  as  a  result,  there  is  left  instead  of  the  alkaline  salt 
of  phosphoric  acid,  an  acid  salt  called  sodium  acid  phos- 
phate. The  alkaline  salt  contains  twice  as  much  sodium 


86  THE    HOME    DIETITIAN 

as  does  the  acid   salt.     The  sodium  acid   phosphate   is 
then  eliminated  by  the  kidneys. 

How   Eliminated 

So,  through  the  lungs  and  kidneys,  acid  wastes  are 
constantly  being  given  off.  The  acidity  of  the  urine  and 
the  elimination  of  carbonic  acid  from  the  lungs  vary 
with  conditions  of  metabolism  so  as  to  maintain  a  nor- 
mal balance  between  the  acid  and  the  alkaline  elements. 
If  for  any  reason  alkali  accumulates  in  excess,  there  is 
eliminated  from  the  kidneys  the  alkaline  phosphoric  salt, 
d'sodium  phosphate  instead  of  sodium  acid  phosphate. 

Besides  sodium  there  are  two  other  important  alkaline 
bases,  potassium  and  calcium,  which,  in  the  form  of 
their  salts,  play  a  leading  part  in  neutralizing  body  acids, 
but  the  surplus  alkali,  or  the  alkali  reserve,  remains  in 
the  body  as  salts  of  sodium.  The  sodium  bicarbonate 
content  of  the  blood  is  looked  upon  as  indicating  the 
state  of  the  acid-base  balance  of  the  blood,  or,  as  quoted 
from  Macleod,  the  "  bicarbonate  represents  the  excess  of 
the  base  [or  alkali]  which  is  left  over  after  all  the  fixed 
acids  have  been  neutralized.  It  represents  the  base  that 
is  available  for  the  neutralization  of  any  such  acids  as 
may  appear.  It  is  a  measure  of  the  reserve  of  buffer 
substance,  or  more  specifically,  the  alkaline  reserve  of 
the  body." —  John  James  Richard  Macleod,  M.  B.,  in 
"  Physiology  and  Biochemistry  in  Modern  Medicine." 

The  Body  Living  upon  Its  Own  Tissue 

It  is  quite  evident,  then,  why  foods  containing  the 
important  bases  —  sodium,  potassium,  and  calcium  - 
must  constantly  be  taken  into  the  body.  If  these  alka- 
line elements  are  furnished  to  the  body  in  insufficient 
quantities  so  that  no  basic  materials  are  at  hand  to  unite 
with  the  sulphuric  acid,  which  results  from  the  metab- 


MINERAL    SALTS  87 

olism  of  protein,  this  acid  seizes  upon  the  salts  of 
the  body  tissues,  which,  as  one  writer  expresses  it, 
"  wrenches  from  their  places  the  bricks  of  the  structure, 
thus  bringing  about  katabolic  destruction  of  the  organ- 
ism." It  is  ever  true  that  when  food  elements  are  not 
supplied  in  sufficient  amounts,  the  body  first  draws  upon 
its  reserve,  and  that  being  exhausted,  upon  its  tissues. 

Source  of  Basic  Salts 

These  alkalies  we  do  not  take  in  as  alkaline  bases, 
which  would  be  irritating,  but  as  salts  in  which  the 
strong  alkalies  are  combined.  When  they  are  absorbed 
and  oxidized,  they  are  set  free  to  neutralize  the  acid 
products  of  metabolism.  Vegetables  are  rich  in  the  alka- 
line salts  that  furnish  the  strong  bases, —  sodium,  po- 
tassium, and  calcium, —  as  well  as  in  other  mineral  salts 
needed  by  the  body.  It  is  hard  for  some  to  understand 
why  fruits  as  well  as  vegetables  help  to  keep  the  body 
alkaline,  but  the  reason  is  this:  salts  of  fruits  are  in 
the  form  of  acid  salts  of  these  three  basic  elements,  and 
are  in  organic  combination  with  oxidizable  food  sub- 
stances. When  these  food  substances  are  oxidized  in  the 
blood  and  tissues,  they  yield  the  strong  bases,  which, 
forming  carbonates,  increase  the  alkalinity  of  the  blood. 

It  is  to  fruits  and  vegetables,  then,  that  we  must  look 
for  our  supply  of  mineral  salts,  and  as  in  the  process  of 
food  analysis  in  the  body,  acid  wastes  are  continually 
being  formed,  so  as  a  result  of  the  synthetic  processes 
of  the  plant  laboratory,  there  is  elaborated  a  preponder- 
ance of  alkaline  material. 

Table  Salt 

Potassium  salts  are  supplied  freely  in  vegetables,  but 
it  seems  necessary  to  take  some  sodium  chloride  in  the 
form  of  table  salt  in  addition  to  t'.iat  furnished  in  vege- 


88  THE    HOME    DIETITIAN 

tables  in  order  that  sufficient  sodium  may  be  supplied  to 
the  body.  Sodium  chloride  (table  salt)  is  the  one  min- 
eral element  that  man  voluntarily  adds  to  his  food. 
While  it  is  often  used  in  excess,  a  certain  amount  is 
needed.  The  reason  for  the  necessity  of  this  addition  of 
salt  depends  upon  the  richness  of  vegetables  in  potas- 
sium rather  than  sodium  salts.  Potassium,  being  a 
strong  alkaline  base,  neutralizes  the  sulphuric  acid  of 
protein  metabolism,  this  resulting  in  the  formation  of 
potassium  sulphate,  in  which  form  it  is  ready  for  elimi- 
nation by  the  kidneys.  This  potassium  sulphate  reacts 
with  the  sodium  chloride  of  the  blood  and  as  a  result 
of  the  interchanges,  potassium  chloride  and  sodium  sul- 
phate are  formed.  This  changes  the  sodium  chloride,  a 
salt  normal  to  the  blood,  to  sodium  sulphate,  one  which  is 
foreign  to  the  blood  content.  Both  it  and  the  potassium 
chloride  are  quickly  eliminated  through  the  kidneys, 
leaving  the  blood  deficient  in  its  sodium  and  chlorine 
supply  unless  additional  salt  is  added  with  the  food. 
However,  Sherman  says  that  sufficient  sodium  would  be 
supplied  the  body  with  one  fourth  the  amount  of  table 
salt  ordinarily  used. 

Deficiency  Diseases;   Demineralized  Foods 

If  animals  are  fed  on  protein,  fat,  and  carbohydrate, 
which  have  been  separated  from  all  mineral  matter,  they 
die  sooner  than  if  fed  nothing  at  all,  poisoned  from  the 
acid  wastes  which  cannot  be  neutralized  or  eliminated. 

In  the  ordinary  diet  some  mineral  salts  are  ever  in- 
gested, yet  they  are  so  often  taken  in  such  limited 
quantities  that  ill  health  and  various  debilitated  con- 
ditions are  frequently  due  to  a  diet  deficient  in  this 
respect.  Without  doubt,  deficiency  diseases  may  as 
readily  result  from  a  diet  in  which  necessary  amounts  of 
mineral  salts  are  lacking  as  from  a  deficiency  in  vita- 


MINERAL    SALTS  89 

mines  and  complete  proteins.  Fortunately,  mineral  salts 
go  hand  in  hand  with  vitamines,  and  in  planning  a  diet 
to  secure  sufficient  vitamines  and  complete  proteins  the 
mineral  salts,  in  a  way,  take  care  of  themselves. 

But  we  can  see  how  an  excessive  carbohydrate  diet, 
with  its  tendency  toward  acid  fermentation  in  the  di- 
gestive tract  and  carbonic  acid  formation  in  the  tissues, 
tends  to  produce  a  condition  of  decreased  alkalinity  of 
the  system.  We  can  see  also  why  cane  sugar,  the  most 
concentrated  form  of  carbohydrate,  should  be  used  in 
moderation;  also  why  honey,  the  natural  fruit  sugar, 
which  carries  in  its  own  combination  its  mineral  salts, 
largely  in  the  form  of  calcium,  is  better  than  refined 
sugars;  why  starch  in  combination  with  mineral  salts, 
as  in  grains  still  retaining  their  outer  layer,  is  better 
than  the  refined  starch  of  white  flour  and  polished 
rice.  It  is  very  plain,  too,  why  excessive  amounts  of 
concentrated  fat  in  the  diet  are  not  the  best,  because 
of  the  tendency  toward  fatty-acid  formation  in  a  clogged 
digestive  tract  or  in  the  backed-up  wastes  of  an  incom- 
plete metabolism.  It  is  plain  to  be  seen  why  fats  al- 
ready in  combination  with  mineral  matter  and  proteins, 
as  cream,  olives,  and  nuts,  are  better  than  the  refined 
variety.  And  again  we  have  one  of  the  best  of  arguments 
in  favor  of  a  vegetarian  diet  with  its  abundance  of  alka- 
line salts  as  against  a  meat  diet  with  its  excess  of 
acid  ash. 

Natural   Foods 

Natural  foods  are  ever  furnished  us  in  a  combination 
that  makes  it  possible  for  the  body  to  care  for  them 
with  the  greatest  ease.  Natural  foods  come  to  us  in 
combination  with  mineral  salts  and  vitamines,  thus  fur- 
nishing with  the  calories  the  wherewithal  to  care  for 
them  and  to  counteract  the  untoward  effects  which 
might  result  from  metabolic  wastes.  As  man  has  en- 


90  THE    HOME   DIETITIAN 

deavored  more  and  more  to  make  his  food  artificial  by 
extracting,  refining,  and  devitalizing,  he  has  made  it 
well-nigh  impossible  for  nature  to  do  her  part,  thus 
bringing  upon  himself  the  handicap  of  a  body  working 
against  great  odds,  in  the  struggle  for  health  and  effi- 
c'ency.  The  following  is  of  interest  in  this  connection: 

"  In  regard  to  the  calcium  content  of  our  food,  inves- 
tigators have  pointed  out  that  there  is  an  insufficiency 
of  calcium  as  well  as  of  other  minerals,  all  of  which 
are  essential  for  perfect  health.  Demineralization  of  our 
daily  food  does  not  seem  to  have  attracted  the  attention 
that  it  deserves.  Sherman  has  stated  that  the  ordinary 
mixed  diet  of  the  Americans  and  Europeans,  at  least 
among  dwellers  in  cities,  is  probably  more  deficient  in 
calcium  than  in  any  other  chemical  element. 

"  McCann  characterizes  our  food  as  '  processed, 
bleached,  colored,  denatured,  degerminated,  demineral- 
ized,  and  chemically  treated.'  Foremost  among  these 
denatured  foods  are  bread,  milk,  cereals,  and  sugar. 
Whole-wheat  bread  is  difficult  to  obtain,  or  is  not  usu- 
ally eaten,  only  white  bread.  The  outer  part  of  the  grain 
of  wheat  has  to  be  removed  to  obtain  white  flour,  which 
is  practically  all  starch.  The  husk  contains  most  of  the 
mineral  matter,  including  calcium,  which  is  discarded. 

"  Nearly  one  fifth  of  the  mineral  contents  of  raw 
sugar  is  calcium.  In  the  manufacture  of  white  sugar 
all  of  the  mineral  matter  is  removed.  Molasses  and 
refiners'  sirup  are  by-products  of  sugar,  and  contain 
practically  all  of  the  mineral  matter.  White  sugar  will 
not  crystallize  unless  the  mineral  matter  is  removed. 
It  is  calcium  which  prevents  crystallization. 

"  Candies  are  made  from  white  sugar  or  glucose, 
neither  of  which  contain  mineral  matter.  Sugar  and 
candy  are  therefore  demineralized  carbohydrates.  Sta- 
tistics show  that  about  eighty-five  pounds  of  sugar  per 


MINERAL    SALTS  91 

capita  are  consumed  every  year  in  this  country.  The 
mineral  loss  in  our  daily  food  from  this  source  alone 
must  be  enormous."-  —  F.  Tweddell,  M.  D.,  in  Medical 
Record,  Jan.  28,  1922. 

Salts,  Where  Found 

For  those  who  may  ask  for  a  summary  of  foods  con- 
taining various  salts,  we  will  say: 

Mineral  salts  are  contained  in  all  natural  unrefined 
foods;  they  are  abundant  in  all  vitamine-containing 
foods.  Especially  are  they  found  in  leafy  vegetables  and 
fresh  fruits.  They  are  found  in  milk,  legumes,  and  nuts. 

Iron  is  found  in  green  vegetables  and  highly  colored 
fruits,  as  cherries,  strawberries,  currants,  etc.  Egg 
yolks  are  rich  in  iron,  as  also  whole  grains,  oatmeal, 
dates,  prunes,  raisins. 

Phosphorus  is  found  in  egg  yolks,  in  milk,  in  wheat 
bran,  in  beans,  peas,  oatmeal,  and  nuts.  Calcium  is 
abundant  in  milk,  in  all  greens,  carrot  tops,  turnip  tops, 
etc.  It  is  also  found  in  oatmeal,  peas,  beans,  nuts,  cit- 
rous fruits,  and  prunes.  Potassium  is  abundant  in  all 
vegetables,  especially  the  leafy  vegetables.  The  potato 
is  rich  in  potassium  salts.  Sodium  is  found  in  all  vege- 
tables, but  not  to  the  same  extent  as  is  potassium. 

All  complete  protein  foods  are  rich  in  sulphur.  The 
body  cannot  utilize  sulphur  except  when  in  combination 
with  the  protein  molecule. 

Acid-forming  elements  predominate  in  meat,  eggs, 
cereals.  Base-forming  or  alkaline  elements  are  greater 
in  fruits,  leafy  vegetables,  potatoes,  carrots,  turnips, 
beans,  peas.  Milk  contains  a  balance  of  the  two. 

In  an  intelligently  planned  diet  there  will  be  avoided 
a  preponderance  of  food  yielding  an  acid  ash  and  there 
will  be  assured  an  abundance  of  those  foods  furnishing 
alkaline  end  products.  It  should  not  be  forgotten  that 
there  may  be  troubles  from  having  the  body  ash  too 
alkaline. 


CHAPTER  XI 
FRUITS 

IN  the  past,  fruit  has  not  been  accorded  its  proper 
place.  While  ever  considered  delightful  and  palatable, 
it  is  only  recently  that  its  real  nutritive  value  has  been 
established.  There  are  few  who  realize  the  importance 
of  a  daily  supply  of  fruit,  preferably  fresh,  in  the  food 
ration.  People  eat  fruit  as  they  often  eat  candy,  oc- 
casionally, irregularly,  and  between  meals.  Many  will 
allow  weeks  to  pass  without  partaking  of  fresh  fruit. 
This  may  be  due  to  thoughtlessness,  lack  of  knowledge, 
or  economic  reasons.  If  any  food  must  be  left  out,  it 
is  usually  fruit,  because  it  is  considered  a  luxury,  not 
an  essential. 

This  is,  however,  a  mistake.  Other  food  will  go  far- 
ther and  in  the  long  run  the  expense  need  be  no  greater 
if  allowance  is  made  for  supplying  the  body  with  the 
vital  food  elements  as  found  in  fruit. 

Fruit  Sugar 

As  has  been  said,  the  caloric  value  of  fruit  lies  in  the 
carbohydrate  which  it  contains.  This  is  found  in  fruit 
as  dextrose  —  glucose  —  which,  as  we  have  seen,  requires 
no  digestion.  Closely  related  to  dextrose,  and  practically 
of  the  same  chemical  composition,  is  levulose.  Together 
these  two  simple  sugars  in  fruit  make  up  what  is  called 
fruit  sugar.  So  in  fruit  we  have  a  naturally  predigested 
food,  together  with  cellulose,  which,  by  reason  of  its 
bulk,  is  a  natural  laxative. 

The  exquisitely  flavored  acid  of  fruit,  which  adds  so 
much  to  its  desirability,  not  only  is  an  appetizer  and  a 

92 


FRUITS  93 

delight  to  the  palate,  but  has  a  definite  favorable  action 
upon  the  digestive  tract.  It  is  a  direct  stimulant  to  the 
gastric  and  intestinal  glands,  increasing  the  flow  of  the 
digestive  juices.  It  also  stimulates  the  muscular  wall 
of  the  stomach  and  bowel.  Thus  in  every  way  it  in- 
creases digestive  activity.  For  those  who  cannot  take 
much  cellulose,  the  fruit  juices  are  a  great  help  by 
reason  of  their  natural  laxative  action. 

Fruit  Acid 

Fruit  acid  also  has  a  decided  antiseptic  action  in 
the  digestive  canal.  It  lessens  bacterial  activity  in  the 
mouth,  sweetens  the  stomach,  helps  to  check  intestinal 
fermentation  and  putrefaction,  and  thus  markedly  less- 
ens the  formation  of  poisons  resulting  from  germ  ac- 
tivity in  the  alimentary  tract.  It  is  well  known  that 
acid  fruits,  such  as  the  lemon,  orange,  and  grapefruit, 
help  to  clear  up  a  coated  tongue,  sweeten  the  breath, 
and  are  good  for  a  torpid  liver  and  biliousness.  The 
bitter  principle  in  grapefruit  is  said  to  act  particularly 
on  the  liver. 

Acid  Salts 

The  good  influence  of  acid  fruits  does  not,  however, 
stop  here,  but  is  felt  in  an  effective  way  after  they  are 
taken  into  the  blood.  The  food  value  of  the  fruit  fills 
a  definite  place  as  fuel  in  the  body  oxidation  processes, 
but  it  is  in  the  effect  upon  the  blood  that  the  most 
beneficial  action  is  obtained.  The  acid  of  fruit  is  in 
the  form  of  acid  salts.  They  are  organic  salts  of  cal- 
cium, sodium,  and  potassium;  for  example,  the  calcium, 
sodium,  and  potassium  citrate  of  the  citrous  fruits. 
These  salts  are  in  combination  with  the  oxidizable  sugar, 
and  in  the'  process  of  their  oxidation  and  disintegra- 
tion they  yield  the  strong  bases  sodium  and  potassium. 


94  THE    HOME   DIETITIAN 

These,  forming  carbonates,  definitely  increase  the  alka- 
linity of  the  blood. 

This  is  a  very  desirable  and  necessary  result,  for,  in 
counteracting  the  acidity  resulting  from  protein  wastes, 
it  helps  to  maintain  the  normal  alkaline  reaction  of  the 
blood,  and  thus  tends  to  neutralize  the  conditions  asso- 
ciated with  lessened  alkalinity  as  found  in  rheumatism, 
gout,  etc.  (See  Chapter  IV,  p.  31.)  The  grape,  the 
prune,  the  plum,  and  the  cranberry,  while  beneficial, 
do  not  affect  the  alkalinity  of  the  blood  to  the  same  ex- 
tent as  the  other  fruits,  for  example,  the  apple,  the 
orange,-  the  lemon,  the  grapefruit,  etc. 

It  was  thought  for  years  that  fruit  increased  a  tend- 
ency toward  rheumatism,  but  we  know  now  that  this 
is  not  the  case,  but  that  most  fruits  lessen  this  tendency, 
and  so  are  among  the  best  rheumatic  cures. 

Nature's  Medicine 

The  vitamine  content  of  fruit  (see  Chapter  IX)  is 
perhaps  its  most  valuable  asset.  It  is  well  known  that 
fresh  fruit,  especially  the  citrous  fruits,  will  cure  scurvy. 
It  is  also  true  that  they  are  valuable  in  other  con- 
ditions of  malnutrition.  Fruit  may  well  be  considered 
nature's  medicine.  Fruits  from  which  the  juice  can 
easily  be  extracted  are  of  especial  worth,  one  reason  for 
the  value  of  the  orange,  the  lemon,  and  the  grapefruit. 
Such  juices  may  often  be  given  invalids  and  children 
who  could  not  take  the  cellulose  accompanying  the 
amount  of  juice  they  may  be  able  to  take  with  ad- 
vantage. These  citrous  fruits  also  rank  first  in  their 
content  of  vitamines  and  mineral  salts. 

From  an  editorial  in  the  Journal  of  the  American 
Medical  Association  we  quote:  "  The  role  of  orange  juice 
in  averting  disaster  under  certain  conditions  of  feed- 
ing, or  in  promoting  the  nutrition  on  certain  dietary 
regimens,  is  beyond  dispute." 


FRUITS  95 

"  In  water-soluble  vitamine,  orange  juice  is  compara- 
ble with  cow's  milk  volume  for  volume.  It  yields  all  the 
present  known  vitamines.  .  .  .  Apples,  pears,  prunes, 
also  contain  the  water-soluble  vitamine." 

"  Fruits  always  regarded  as  palatable  are  having 
their  real  worth  established  at  length  in  a  scientific 
way." 

Tomatoes  a  Substitute  for  Orange  Juice 

Tomatoes  have  been  found  to  rank  with  oranges  in 
their  content  of  alkaline  salts  and  vitamines.  While 
often  used  as  a  vegetable,  dietetically  they  must  be  con- 
sidered a  fruit.  When  oranges  are  found  too  expensive 
or  are  difficult  to  obtain,  babies  can  be  saved  from 
scurvy  by  giving  them  tomato  juice,  and  that  even  from 
canned  tomatoes.  This  has  been  done  with  gratifying 
results  among  the  poorer  classes  in  large  cities. 

Fruits  also  contain  a  small  amount  of  protein,  usually 
about  5  per  cent  of  their  food  value.  The  orange  and 
the  grapefruit  contain  as  high  as  6  or  7  per  cent  of 
their  food  value  in  protein.  The  food  value  of  the 
banana  is  7  or  8  per  cent  protein.  While  fruit  can- 
not in  any  sense  be  depended  upon  to  supply  protein, 
yet,  for  some  reason  not  well  understood,  those  who  eat 
an  abundance  of  fresh  fruit  seem  able  to  do  well  on  a 
diet  furnishing  a  smaller  amount  of  protein  than  do 
those  who  eat  little  or  no  fruit.  Perhaps  this  is  partly 
due  to  the  "  protein  sparing  "  action  of  the  fruit  sugar 
(see  page  95),  and  partly  to  the  high  vitamine  content 
of  the  fruit  (see  page  75). 

Stewed   Fruit 

The  dietetic  value  of  fruit  is  often  counteracted  to  an 
extent  by  the  large  amount  of  cane  sugar  added.  It 
will  be  found  a  great  advantage  to  eat  fruit  in  as  nat- 


96  THE    HOME   DIETITIAN 

ural  a  condition  as  possible.  When  sugar  is  added  to 
stewed  fruits,  it  should  be  cooked  with  the  fruit.  In 
this  way  the  heat  and  fruit  acid  tend  to  change  the 
cane  sugar  into  the  simple  predigested  dextrose,  which 
results  in  a  more  natural  and  more  easily  digested  com- 
bination. While  stewed  fruit  is  better  than  none,  it 
can  never  quite  take  the  place  of  fresh  fruit.  The 
heating,  to  an  extent  at  least,  devitalizes  the  fruit,  and 
the  added  sugar  tends  to  counteract  the  alkalizing 
effect  of  the  fruit.  It  seems  that  the  more  acid  the  fruit 
the  more  stable  are  its  vitamines.  It  is  said  that  the 
juice  of  some  berries,  especially  the  raspberry,  may  be 
boiled  an  hour  without  losing  its  vitamine  value,  also 
that  lemon  juice  may  be  boiled,  bottled,  and  kept  indefi- 
nitely without  losing  its  vitality.  The  acidity  of  the 
tomato  seems  to  thus  stabilize  its  vitamine,  so  that  the 
juice  of  canned  tomatoes  can  be  made  to  take  the  place 
of  orange  juice  when  the  latter  is  not  obtainable. 

The   Banana 

While  it  cannot  take  the  place  of  acid  fruits,  and 
dietetically  may  in  some  ways  be  classed  as  a  vegeta- 
ble, the  banana  is  a  food  of  great  worth.  Its  food  value 
is  similar  to  that  of  the  potato.  Its  percentage  of  protein 
is  somewhat  lower,  but  its  proportion  of  alkaline  min- 
eral salts  is  about  the  same.  Too  often  it  is  eaten  un- 
ripe, and,  in  this  form,  is  indigestible  because  of  its  high 
content  of  raw  starch.  In  the  process  of  ripening,  this 
starch  is  changed  to  sugar,  and  the  ripe  banana,  with 
its  yellow-brown  speckled  peel,  is  a  food  delightful  in 
flavor  and  easy  of  digestion.  It  should,  however,  be 
properly  masticated.  Too  often  it  is  gulped  down  with- 
out sufficient  mastication.  Ordinarily  a  ripe  banana 
eaten  slowly  and  well  masticated  should  cause  no  trou- 
ble, and  may  be  well  taken  by  children. 


FRUITS  97 

How  Fruit  May  Be  Eaten 

Some  with  catarrhal  stomachs  find  that  they  do  not 
take  fruit  well  because  of  an  irritated  condition  of  the 
mucous  membrane  brought  on  by  some  other  cause.  In 
this  condition  the  stomach  lining  cannot  bear  even  the 
normal  stimulation  of  the  fruit  acid  and  its  cellulose. 
The  trouble  is  not  with  the  fruit,  but  with  the  primary 
state  of  gastric  irritation.  In  some  others,  due  to  ab- 
normal excitation  or  naturally  irritable  mucous  lining, 
an  excessive  amount  of  the  normal  acid  of  the  stomach 
is  secreted,  and  the  already  irritated  mucous  membrane 
does  not  seem  to  bear  well  the  addition  of  any  more 
acid,  even  though  it  be  the  normal  acid  prepared  by 
nature  for  us  as  food.  However,  even  in  these  abnormal 
states,  there  is  usually  some  way  by  which  the  fruit  or 
fruit  juice  can  be  taken,  and  many  of  these  persons  do 
well  if  they  eat  fruits  alone,  not  trying  to  combine  them 
with  other  foods.  Many  who  cannot  eat  fruit  can  drink 
fruit  juice,  say  an  hour  before  meals.  Others  may  find 
that  a  fruit  meal  agrees  with  them  if  no  other  food  is 
taken.  This  may  be  a  fruit  breakfast  or  a  fruit  lunch. 

Dried  fruits,  as  raisins,  prunes,  dates,  figs,  are  a  val- 
uable source  of  fruit  sugar,  and  may  be  used  alone,  or 
in  combination  with  nuts  and  cereal  to  make  very 
pleasing  additions  to  any  meal.  For  children  they  are 
invaluable  as  a  means  of  satisfying  the  desire  for 
sweets. 

Nuts  and  Olives 

Botanically,  nuts  and  olives  may  be  classified  as 
fruits,  and  for  sake  of  convenience  we  will  discuss  them 
here.  Nuts  are  of  great  value  in  the  vegetarian  diet  as 
a  natural  source  of  fats  and  protein.  The  greater  part 
of  the  food  value  of  nuts  is  fat.  The  protein  varies 
from  10  per  cent  of  the  food  value  in  the  walnut,  to 

7 


98  THE    HOME    DIETITIAN 

15  to  18  per  cent  in  the  almond.  The  peanut,  a  legume 
rather  than  a  nut,  contains,  of  its  total  value,  about  20 
per  cent  protein.  Nuts  contain  practically  no  carbohy- 
drate. The  fat  of  the  nut  is  in  the  best  form  for  di- 
gestion, because  it  is  already  in  a  combined,  emulsified 
state. 

The  protein  of  the  nut  is  of  a  very  good  quality. 
On  this  point,  see  quotation,  page  209.  As  a  natural 
source  of  concentrated  food,  supplying  the  most  calories 
in  the  least  bulk,  nuts  should  have  first  place  and  should 
be  eaten,  not  as  knickknacks,  but  with  true  regard  for 
their  actual  nutritive  value.  Too  often  they  are  eaten 
after  a  meal,  when  their  food  value  is  not  needed  and 
only  imposes  an  extra  tax  on  digestion  and  metabolism. 
But  if  they  are  allowed  to  take  a  definite  place  in  sup- 
plying the  body  needs  and  are  properly  masticated,  they 
are  a  food  of  great  value. 

Ripe  olives,  properly  prepared,  are  a  valuable  source 
of  fat,  and  may  be  eaten  with  good  results  by  persons 
who  cannot  well  take  sufficient  fat  in  any  other  form. 
They  may  be  eaten  at  any  or  every  meal,  and  if  prop- 
erly masticated,  are  easily  digested  and  assimilated. 
There  is  no  question  but  that  the  advantages  looked  for 
in  the  use  of  butter,  may  be  obtained  from  the  proper 
use  of  olives  and  nuts,  providing  the  leaves  of  plants  are 
used  freely  to  supply  necessary  vitamines  (see  page 
103). 


"  There  is  in  fruits  and  vegetables  an  appar- 
ent safeguard." — Journal  of  the  American  Med- 
ical Association. 


CHAPTER  XII 
VEGETABLES 

A  Universal  Food 

No  other  food  is  so  universally  used  by  all  classes 
as  the  vegetable.  No  daily  ration  seems  complete  with- 
out it,  no  matter  how  elaborate  the  other  foods  may  be. 
Few  live  so  largely  on  a  meat  diet  that  they  do  not 
feel  the  need  of  the  accompanying  vegetable  to  make 
their  meal  satisfactoiy.  And  to  those  who  have  adopted 
a  flesliless  diet  it  becomes,  more  than  ever,  an  impor- 
tant part  of  their  dietary,  and  greater  dependence  is 
placed  upon  it  in  the  making  up  of  their  daily  ration. 
Greater  thought  and  care  must  then  be  accorded  its 
preparation  and  more  attention  paid  to  the  part  it 
plays  in  the  meal. 

Why  of  Value 

Vegetables  are  valuable  because  of  their  cellulose, 
which,  as  before  stated,  serves  as  necessary  bulk;  be- 
cause of  their  richness  in  mineial  salts  so  essential  to 
the  blood  and  tissues;  because  of  the  great  amount  of 
vitamines  they  supply,  without  which  the  organic  proc- 
esses could  not  be  carried  on;  and  because  of  actual 
caloric  food  value,  which  is  in  very  small  amounts  in 
some  vegetables,  but  more  abundant  in  others.  Leafy 
vegetables,  as  lettuce,  spinach,  celery,  cabbage,  etc., 
while  low  in  calories,  furnish  a  goodly  portion  of  these 
calories  in  the  form  of  complete  proteins.  Green  vege- 
tables contain  a  large  amount  of  water. 

Botanically,  vegetables  may  be  classified  as  follows: 

1.  Roots  —  carrots,   turnips,   beets,   parsnips. 

2.  Tubers  —  potatoes,   sweet  potatoes. 

99 


100  THE   HOME   DIETITIAN 

3.  Leaves  —  lettuce,  cabbage,  cauliflower,  asparagus, 

spinach,  greens,  etc.     Onions  are  underground 
leaves. 

4.  Seeds  or  legumes  *  —  peas,  beans,  lentils,  peanuts, 

soy  beans. 

The  Seed  Versus  the  Leaf 

From  a  dietetic  standpoint,  McCollum  divides  vege- 
tables (including  grains)  into  two  classes:  the  leaf 
(leafy  vegetables)  and  the  seed  (grains  and  legumes). 
The  seed  of  the  plant  is  its  storehouse  and,  aside  from 
the  germ,  contains  no  living  matter.  The  seed,  while 
rich  in  caloric  food  value,  is  low  in  inorganic  salts; 
is  deficient  in  the  fat-soluble  vitamine,  and  its  protein 
is  not  complete. 

In  contradistinction  to  the  seed,  the  leaf  of  the  plant 
is  made  up  largely  of  living  cells.  It  is  the  part  of  the 
plant  that  breathes;  it  is  the  laboratory  of  the  plant 
where  starches,  fats,  and  proteins  are  built  up.  This 
portion  of  the  plant  contains  those  elements  in  which 
the  seed  is  relatively  poor. 

The   Potato 

Roots  and  tubers,  while  not  seeds,  must  to  an  extent 
rank  with  the  seeds,  as  they  are  largely  composed  of 
storage  material.  The  part  of  these  vegetables  which 
may  be  classified  with  the  leaves  is  the  outer  portion 
just  under  the  skin,  or  that  part  usually  discarded  in 
paring.  We  quote :  "  The  potato  is  to  be  classed  with 
the  seeds  in  its  dietary  properties  because  it  consists 
largely  of  reserve  food  materials  and  relatively  little  of 
cellular  elements.  The  results  available  indicate  that  if 
the  potato  is  steamed  and  the  thin  paper-like  skin  re- 
moved without  the  loss  of  the  cellular  layer  which  lies 

1  In  this  class  may  also  be  placed  the  grains. 


VEGETABLES  101 

just  underneath,  it  will  contain  relatively  more  of  the 
fat-soluble  A,  a  lack  of  which  leads  to  the  development 
of  the  peculiar  eye  conditions  previously  described,  than 
do  the  cereal  grains.  ...  It  would  seem  that  a  potato 
which  is  pared  in  the  ordinary  way  and  the  paring  dis- 
carded, is  changed  in  its  dietary  properties  in  much  the 
same  way  as  is  the  rice  kernel  during  the  polishing 
process."- -McColm,  in  "The  Newer  Knowledge  of 
Nutrition,"  p.  47. 

Comparative   Costs 

And  again :  "  We  may  safely  compare  the  cost  of  the 
cereal  grains  or  the  legumes  with  each  other,  or  with 
the  tubers  such  as  the  potato  or  the  sweet  potato,  or  with 
the  root  foods.  It  is  not  possible  to  compare  the  cost 
of  any  of  these  with  milk  or  the  leafy  vegetable,  such 
as  cabbage,  cauliflower,  Swiss  chard,  collards,  Brussels 
sprouts,  onions,  lettuce,  celery  tops,  spinach,  turnip  tops, 
and  other  leaves  employed  as  greens.  Milk  and  the 
leafy  vegetables  are  to  be  regarded  as  protective  foods. 
.  .  .  The  leaves  should  not  be  regarded  as  foods  of 
low  value  because  their  content  of  protein,  fat,  and  car- 
bohydrate is  low,  and  the  content  of  water  high.  .  .  . 
But  they  have  a  peculiar  value  .  .  .  which  makes 
them  stand  in  a  class  by  themselves  among  vegetable 
foodstuffs."  -Id.,  pp.  141,  142.  The  proper  combina- 
tion of  vegetables  as  to  their  kinds  and  parts  becomes 
then  quite  apparent. 

How  Much  Cellulose? 

The  bulk  of  most  vegetables  is  cellulose.  The  cellu- 
lose of  some  vegetables  is  tougher  and  more  indigestible 
than  that  of  others.  The  cellulose  of  vegetables  is  often 
more  digestible  raw  than  cooked,  as  for  example,  cab- 
bage, which  can  be  eaten  raw  by  many  who  find  it  im- 


102  THE    HOME    DIETITIAN 

possible  to  take  it  cooked.  The  amount  of  cellulose  well 
tolerated  by  the  digestive  tract  depends  on  the  inherent 
strength  of  its  muscular  wall.  Some  can  take  a  large 
amount  of  bulky  food;  others  find  food  containing  much 
cellulose  difficult  of  digestion.  All,  however,  need  a  cer- 
tain portion  of  cellulose,  or  roughage,  to  stimulate  the 
bowel  to  normal  muscular  activity.  Much  depends  on 
the  preparation  of  the  food,  the  time  spent  in  eating  it, 
and  the,  thoroughness  with  which  it  is  masticated.  With 
thorough  mastication  many  of  the  bulkier  foods  ordi- 
narily considered  indigestible  may  be  well  taken  and 
properly  handled  by  the  digestive  tract. 

All  vegetables  are  rich  in  mineral  salts,  the  leafy  vege- 
tables especially  so,  as  we  have  seen.  The  potato  also 
contains  an  abundance  of  alkaline  salts,  and,  for  tbns 
reason,  is  useful  in  conditions  where  it  is  desirable  to 
render  the  blood  more  alkaline.  This,  no  doubt,  is  the 
reason  why  the  combination  of  "  meat  and  potatoes " 
has  always  been  so  satisfactory;  the  acid  ash  of  meat 
metabolism  being  neutralized,  to  an  extent,  by  the  alka- 
linity of  the  potato. 

An  Iron  Tonic 

Green  vegetables  are  particularly  valuable  for  the 
iron  salts  they  contain,  thus  being  very  helpful  in  cases 
of  anemia.  The  iron  obtained  in  this  way  is  appropri- 
at3d  by  the  body  to  a  much  greater  degree  than  that 
taken  as  "  iron  tonic  "  out  of  a  bottle.  The  green  color- 
ing matter  of  the  plant  is  known  as  chlorophyl.  Chlo- 
rophyll is  the  respiratory  and  starch-making  portion  of 
the  plant,  and  is  essential  not  only  to  plant  life  but  to 
animal  life  as  well.  Hemoglobin,  the  red  coloring  mat- 
ter of  the  blood,  is  analogous  to  the  chlorophyl  of  the 
plant,  and  just  as  chlorophyl  is  necessary  to  plant  life, 
so  is  hemoglobin  necessary  to  animal  life.  Green  vege- 


VEGETABLES  103 

tables  contain  substances  closely  related  to  the  red  of 
the  blood,  and  the  quality  of  the  hemoglobin  of  the  blood, 
with  its  iron  content,  may  be  altered  materially  by  a 
deficiency  or  an  abundance  of  these  important  and 
vitalizing  fluids. 

The  vita/mines  present  in  these  green  and  leafy  vege- 
tables make  them  invaluable  as  an  article  of  diet,  both 
for  the  invalid  and  for  the  person  in  normal  health;  for 
the  child  as  well  as  for  the  adult.  For  the  child  they 
are  especially  valuable  because  of  the  "  fat-soluble " 
vitamine  they  contain,  which  has  to  do  with  normal 
growth  and  development.  (See  Chapter  IX.) 

Spring   Fever 

In  cities  and  countries  where  green  vegetables  can- 
not be  obtained  during  the  winter  months,  people  often 
suffer  the  results  of  a  vitamineless  diet.  Dr.  Evans,  a 
noted  health  writer,  says  that  one  half  of  the  people  in 
the  cities  have  a  touch  of  scurvy  every  winter.  This 
may  account  for  the  epidemics  of  "  spring  fever "  so 
prevalent  as  winter  ends,  and  the  use  of  liver  pills  and 
blood  purifiers  at  this  time  of  the  year.  All  vegetables, 
however,  contain  vitamines,  and  when  green  vegetables 
cannot  be  obtained  and  fruits  are  expensive,  the  proper 
preparation  of  winter  vegetables  may  supply  necessary 
vitamines.  The  skins  of  winter  vegetables  partake  of 
the  nature  of  the  leaf,  and  may  be  utilized  in  such 
a  way  as,  to  some  extent,  to  take  the  place  of  leafy 
vegetables. 

While  those  parts  of  the  vegetable  which  are  made 
up  largely  of  caloric  food  material  in  storage,  are  com- 
paratively low  in  protein,  the  protein  value  of  the  leaf 
and  skin  is  relatively  high  and  of  the  best  quality.  It 
is  interesting  to  note  that,  while  the  total  food  content 
of  leafy  vegetables  is  often  low,  of  this  low  total  a  high 


104  THE    HOME   DIETITIAN 

proportion  may  be  protein,  ranging  from  25  to  40  or 
even  50  per  cent. 

The  actual  energy  value  of  vegetables  varies  within 
rather  wide  limits  from  the  cabbage,  containing  2  to  5 
calories  to  the  ounce,  to  the  bean,  furnishing  a  food 
supply  of  65  calories  to  the  ounce. 

Hot  Weather  Food 

Green  vegetables  contain  much  water,  as  high  as 
from  80  to  92  per  cent.  For  this  reason  an  animal 
feeding  largely  upon  leaves  and  green  vegetables  drinks 
much  less  water  than  one  subsisting  upon  a  diet  of 
grain.  For  this  reason  green  vegetables  are  especially 
good  as  "hot  weather  food." 

Raw  Foods 

The  question  of  the  preparation  of  vegetables  is  a 
most  important  one.  Uncooked  vegetables  contain  the 
highest  percentage  of  vitamines,  and  such  vegetables  as 
carrots,  turnips,  cabbage,  as  well  as  lettuce,  water  cress, 
tomatoes,  celery,  etc.,  may  be  eaten  raw  with  great  ad- 
vantage. These  prepared  in  the  form  of  salads  may  be 
served  in  a  most  attractive  way.  (See  recipes,  Chapter 
XXXI.)  In  this  they  may,  to  an  extent,  take  the  place 
of  fruit.  Says  Leonard  Williams,  M.  D.,  of  London,  in 
the  British  Medical  Journal,  of  July  31,  1920,  in  speak- 
ing of  an  exclusive  raw  food  diet :  "  Now  this  intensive 
vitamine  dietary,  the  exclusion,  that  is,  of  all  cooked 
foods  and  drinks,  is  extraordinarily  efficacious  thera- 
peutically.  It  not  only  assists  other  forms  of  treatment 
by  improving  the  soil  and  re-enforcing  the  defenses, 
but  it  is  of  itself,  positively  curative  in  most  forms  of 
chronic  disease." 

The  process  of  cooking  unfortunately  often  greatly 
lessens  the  nutritive  value  of  vegetables.  It  is  possible, 


VEGETABLES  105 

however,  so  to  prepare  and  cook  them  that  they  will 
not  lose  their  nutritive  and  vital  elements;  and  it  is 
very  important  that  this  be  accomplished. 

A  Waste 

The  ordinary  method  of  vegetable  preparation  in- 
cludes the  removing  of  the  skins  and  those  parts  con- 
taining the  tough,  more  fibrous  portion  of  cellulose,  such 
as  celery  tops,  asparagus  butts,  pea  pods,  etc.  These 
parts,  however,  contain  many  of  the  valuable  salts  and 
vitamines  and  often  a  comparatively  large  amount  of 
protein.  For  example,  the  greater  part  of  the  protein 
nourishment  lies,  with  the  salts  and  vitamines,  just 
underneath  the  skins  of  such  vegetables  as  the  potato, 
carrot,  etc.,  and  so  is  lost  when  these  are  thrown  away. 
(See  quotation,  page  100.)  Carrot  tops  are  said  to  be 
particularly  rich  in  calcium  or  lime  salts. 

Food  Value  Lost 

When  vegetables  are  boiled,  a  considerable  portion  of 
the  remaining  nitrogenous  elements  and  vitamines  passes 
into  the  broth,  and  not  infrequently  is  thrown  down  the 
sink,  instead  of  being  used  where  it  is  so  often  sorely 
needed  in  the  supplying  of  body  needs.  "  When  potatoes 
are  peeled,  allowed  to  stand  in  cold  water  and  then 
boiled,  they  lose  about  50  per  cent  of  their  protein  and 
40  per  cent  of  the  mineral  matter  and  vitamines.  As 
usually  prepared  and  cooked,  carrots  lose  40  per  cent  of 
their  protein  food  value  and  25  per  cent  of  their  sugar." 
The  cooking  of  other  vegetables  results  in  about  the 
same  loss.  In  this  way  much  of  the  delightful  flavor 
is  lost,  and  the  vegetables  lose  to  a  great  extent  their 
satisfying  palatability. 

To  Prevent  Waste 

These  losses  may  be  prevented  in  a  number  of  ways. 
Vegetables  may  be  cooked  without  paring.  They  may 


106  THE    HOME    DIETITIAN 

be  baked,  boiled,  or  steamed,  the  skins  being  removed 
just  before  serving,  or  eaten,  as  in  the  case  of  baked 
potatoes.  A  very  satisfactory  way  to  prepare  vegetables 
is  to  steam  them.  Even  better  than  to  put  them  directly 
into  a  steamer,  is  to  put  in  the  steamer  the  vessel  in 
which  the  vegetable  is  to  be  cooked;  cover  well,  so  that 
the  steam  will  come  in  contact  with  the  vegetable  over 
the  sides  of  the  smaller  pan.  This  method  retains  in 
the  vegetable  all  the  valuable  elements  and  gives  it  a 
very  delicious  flavor. 

The  water  in  which  vegetables  are  boiled  should  never 
be  thrown  away,  but  should  be  saved  and  used  as  a 
basis  for  soups  and  gravies.  Better  still,  cook  them  in 
a  small  amount  of  water  so  that  there  is  no  broth  left. 
They  should  always  be  cooked  in  salted  water.  The  salt 
in  the  water  helps  to  prevent  the  extraction  of  the  salts 
from  the  vegetables. 

Vegetable   Extracts 

As  a  variation  and  for  those  members  of  the  family 
not  able  to  digest  cellulose  well,  vegetable  broths  and 
purees  may  be  prepared  in  such  a  way  as  to  supply  all 
valuable  vegetable  elements  except  the  cellulose.  The 
vegetables,  having  been  thoroughly  cleansed  with  a 
brush,  may  be  cut  up  and  cooked  without  paring,  or  the 
parings  may  be  cooked  by  themselves  (see  recipe  24, 
Chapter  XXXI),  and  in  this  way  the  nutritive  elements 
extracted.'  This  being  a  process  of  extraction,  instead 
of  retention,  the  cooking  may  be  more  prolonged  than 
otherwise  and  better  at  the  simmering  point,  i.  e., 
190°  F.  instead  of  212°  F.,  the  ordinary  boiling  tem- 
perature. A  somewhat  prolonged  cooking  of  one  and 
a  half  or  two  hours  tends  to  quite  thoroughly  extract 
the  food  elements  from  the  vegetable.  In  this  case  the 
vegetables  should  be  cooked  in  unsalted  water,  this  tend- 


VEGETABLES  107 

ing  to  draw  the  salts  from  the  vegetables  into  the  broth. 
Pressing  through  a  colander  or  sieve  will  separate  the 
skins  and  cellulose  and  leave  practically  all  the  nutri- 
tive elements  in  the  broth  and  puree.  The  elements 
thus  extracted  contain  the  meaty  savor  which  is  an  ap- 
petizer and  tonic. 

Delicious  soups  may  be  made  in  this  way,  and  from 
the  standpoint  of  economy  they  are  well  worth  while,  as 
parts  are  used  that  ordinarily  find  their  way  to  the  gar- 
bage can.  Outside  lettuce  leaves,  celery  tops,  tops  of 
turnips,  beets,  carrots,  the  tougher  portions  of  aspara- 
gus, and  even  pea  pods  may  be  boiled,  and  from  these 
portions  will  thus  be  obtained  food  elements  that  will 
greatly  increase  the  total  value  of  the  vegetable.  Pea 
pods  may  be  boiled  and  then  the  peas  cooked  in  the  pea 
pod  broth.  The  water  in  which  the  asparagus  butts 
have  been  boiled,  may  be  used  in  which  to  cook  the  as- 
paragus tips.  Prepared  in  these  economical  ways,  vege- 
tables no  longer  remain  simply  carbohydrate  food,  but 
may  be  made  to  supply  to  the  body  a  comparatively 
large  portion  of  nitrogenous  material. 

Vegetables  should  be  cooked  until  tender,  but  care 
should  be  taken  that  they  are  not  overcooked  or  allowed 
to  become  water  soaked.  Cooking  is  often  prolonged 
much  beyond  the  necessary  time,  and  this  at  a  high 
temperature,  which  tends  to  devitalize  the  food  and  in 
no  way  increases  its  tenderness  or  desirability.  The 
prolonged  subjection  to  heat  may  even  toughen  it. 
Spinach  is  often  cooked  one  to  one  and  a  half  hours, 
when  cooking  from  twenty  to  thirty  minutes  is  usually 
quite  sufficient,  leaving  the  vegetable  much  more  desir- 
able as  a  food., 

Effect  of  Cooking  on  Vitamine 

Just  how  much  cooking  destroys  vitamines  is  a  de- 
bated question.  While,  as  a  general  principle,  we  must 


108  THE    HOME   DIETITIAN 

concede  that  raw  food  contains  more  vital  elements  than 
cooked,  and  that  every  one  should  eat  some  raw  food 
daily,  yet  many  vitamines,  especially  those  of  vegetables, 
are  in  stable  combination  and  the  effect  upon  them  of 
cooking  may  be  very  slight.  Dr.  George  F.  Still,  of 
London,  is  quoted  in  the  British  Medical  Journal  of  July 
31,  1920,  as  follows :  "  It  has  been  generally  supposed 
that  the  antiscorbutic  vitamine  is  easily  destroyed  by 
heat;  in  curious  apparent  contradiction  of  this  view  is 
the  powerful  antiscorbutic  effect  of  potato  after  being 
thoroughly  cooked.  One  of  the  most  rapid  cures  for  in- 
fantile scurvy  is  floury  baked  potato,  which  is  given 
beaten  up  with  the  infant's  food.  If  there  is  a  differ- 
ence between  foods  in  this  respect,  it  may,  I  would  sug- 
gest, depend  not  merely  on  the  amount  of  vitamine 
present,  but  upon  the  manner  in  which  the  vitamine  is 
contained  in  the  food;  one  can  imagine,  for  instance, 
that  the  vitamine  may,  to  borrow  a  chemical  phrase,  be 
in  looser  combination  in  one  food  than  in  another,  and 
so  may  be  more  exposed  to  destruction  by  heat." 

The  nutritive  value  of  vegetables  has  become  estab- 
lished beyond  a  doubt.  It  is  important  that  they  form 
a  large  part  of  every  daily  ration,  not  only  for  the  adult, 
but  also  for  the  child.  They  should  be  considered  a 
real  food  rather  than  merely  a  relish,  and  they  will 
occupy  a  place  in  the  role  of  nutrition  that  they  have 
never  had  when  housewives  learn  to  prepare  them  in 
such  a  way  as  to  retain  all  their  food  elements. 


"  Thou  shalt   eat   the   herb   of   the   field." — 
Bible. 


CHAPTER  XIII 

BREADS  AND  CEREALS 

The  Staff  of  Life 

BREAD  is  the  staff  of  life  and  without  the  homely 
loaf  we  would  often  feel  unsatisfied,  even  though  sur- 
rounded by  the  most  tasty  viands.  Some  one  has  well 
said  that  "  there  is  true  religion  in  a  loaf  of  good 
bread."  Today,  when  the  cost  of  living  is  high,  the 
quality  of  our  bread  becomes  a  q'uestion  of  the  greatest 
importance,  and  when  we  are  confronted  with  the  fact 
that  the  refined  flour  of  today  has  been  robbed  of  life- 
giving  properties  by  the  removal  of  the  outer  layer  of 
the  grain,  it  behooves  us  to  cultivate  a  taste  for  real 
Graham  bread  and  demand  whole  flour  instead  of  that 
which  has  been  devitalized.  (See  Chapter  IX.) 

The  Whole  Grain 

Whether  bread  is  made  from  wheat,  rye,  or  corn,  flour 
containing  the  whole  grain  should  be  obtained  whenever 
possible.  In  this  way  not  only  are  the  valuable  vita- 
mines  and  mineral  salts  saved  to  the  body,  but  the  ex- 
tra bulk  is  a  great  help  in  the  prevention  and  treatment 
of  constipation.  One  of  the  most  generally  recognized 
foods  indicated  in  constipation  is  bread  containing  an 
excess  of  bran.  However,  the  addition  of  sterilized 
bran  to  bread  made  from  devitalized  flour,  while  of 
some  benefit,  cannot  take  the  place  of  bread  containing 
both  the  coarse  outer  covering  and  the  vitamines  which 
would  be  found  in  Graham  bread  made  from  real  Gra- 
ham flour. 

Genuine  whole-wheat  or  Graham  flour  is  difficult  to 
obtain,  but  its  value  as  a  food  is  worthy  of  a  determined 

109 


110  THE   HOME   DIETITIAN 

effort  to  obtain  it  and  to  eat  it  every  day  as  bread, 
raisin  bread,  nut  bread,  or  gems.  The  flour  sold  as 
whole  wheat  is  usually  a  combination  of  a  few  of  the 
several  low  grades  of  flour,  middlings,  and  bran  pro- 
duced by  the  roller  processes,  and  so  does  not  contain 
vitamines. 

After  being  ground,  the  outer  layer  containing  the 
germ  will  not  keep  more  than  a  few  weeks  and  so  can- 
not be  stored  indefinitely.  For  this  reason  the  manu- 
facturers will  not  keep  it  on  hand  until  the  demand  for 
it  is  greater  than  it  has  been.  But  the  occasional  small 
miller  can  often  be  found  who  will  grind  the  whole 
wheat  berry,  as  it  is  called  for,  or  the  wheat  can  be 
ground  at  home  in  a  small  mill  or  even  in  a  coffee  mill. 

Home-Ground  Wheat 

Several  families  may  club  together  and  buy  a  mill, 
in  which  a  supply  of  whole-wheat  flour  may  be  ground 
for  them  all.  This  has  been  done  by  many  with  satis- 
factory results.  We  are  too  often  prone  to  do  the  easy 
thing,  but  a  sense  of  the  impoitance  of  having  the  best, 
most  wholesome  bread  will  result  in  a  determined  effort 
to  obtain  it,  and  "  where  there  is  a  will  there  is  a  way." 

Whiteness  Not  an  Indication  of  Quality 

When  it  is  not  possible  to  obtain  real  whole-wheat 
bread,  a  general  rule  that  is  quite  safe  to  follow  is  that, 
other  things  being  equal,  dark  bread  is  better,  even 
though  baker's  bread,  than  white,  in  that  it  undoubtedly 
is  richer  in  mineral  salts.  A  step  has  been  taken  in 
the  right  direction  when  the  public  can  be  made  to  see 
this  and  to  get  away  from  the  idea  that  the  better  the 
bread  the  whiter  it  is.  It  is  well  to  remember  that 
natural  foods  have  color  as  compared  with  refined  foods ; 
e.  g.,  brown  sugar  has  mineral  elements  of  which  the 


BREADS   AND   CEREALS  111 

white  refined  variety  is  entirely  devoid.  Fortunately, 
we  are  not  dependent  upon  bread  alone  for  vitamines, 
and  what  we  miss  by  being  obliged,  at  times,  to  eat 
devitalized  bread  we  may  make  up  by  using  freely  of 
other  vitamine-containing  foods. 

Fresh   Bread 

Given  bread  made  from  flour  which  is  of  the  right 
quality,  it  should  be  prepared  in  a  way  that  will  permit 
of  easy  digestion.  Bread  raised  with  yeast,  most  com- 
monly used  and  undoubtedly  the  best,  should,  of  course, 
be  light  and  sweet;  but  aside  from  these  qualities  there 
is  another  qualification  to  which  we  pay  little  attention, 
and  that  is  the  process  through  which  bread  passes 
after  it  is  baked.  Fresh  bread  is  difficult  of  digestion, 
and  this  difficulty  is  enhanced  by  the  common  addition 
to  it  of  large  amounts  of  butter.  Being  soft,  it  is  not 
thoroughly  masticated,  and  it  is  often  swallowed  in 
masses  which  become  soggy  in  the  stomach.  The  gas- 
tric juice  is  unable  to  mix  thoroughly  with  it,  digestion 
is  delayed,  and  fermentation  results.  On  the  other  hand, 
if  bread  is  allowed  to  stand  for  twenty-four  hours  or 
more,  important  changes  take  place  which  eliminate  its 
indigestible  qualities.  It  becomes  drier,  separates  into 
small  particles  more  readily,  and  certain  chemical 
changes  actually  occur  in  the  protein  as  the  bread 
becomes  stale  that  greatly  increase  its  digestibility. 

Oven  Toast  or  Zwieback 

These  conditions  are  enhanced  when  bread  is  twice 
baked,  as  in  oven  toast,  and  for  one  with  a  weak  di- 
gestion there  is  no  bread  so  well  received  by  the 
stomach.  The  starch  is  partly  digested  by  the  extreme 
heat  and  we  speak  of  it  as  being  "  dextrinized."  Its 
brittleness  allows  of  easy  solution  by  the  digestive  fluids. 


112  THE    HOME   DIETITIAN 

The  Wrong  Way 

Toast,  as  often  made,  is  not  better  than  fresh  bread. 
A  slice  of  bread  is  taken  and  browned  superficially, 
leaving  the  center  soft  and  often  more  like  fresh  bread 
than  if  it  had  not  been  toasted.  This  is  then  covered 
with  butter  and  reheated,  making  a  combination  in  the 
"  hot  buttered  toast "  as  ordinarily  served,  that  can 
hardly  be  called  hygienic,  even  though  commonly  con- 
sidered under  the  head  of  invalid  dietary.  The  thorough 
mastication  of  hard  breads  would  tend  to  prevent  much 
of  the  premature  decay  of  teeth  so  prevalent  among  the 
American  people.  Here  as  elsewhere  are  often  seen  the 
results  of  lack  of  exercise,  and  the  teeth  tend,  because 
of  disuse,  to  fall  into  degeneration  and  premature 
decay. 

Devitalized   Bread 

Baking  powder  and  soda  breads  are  not  the  best  for 
several  reasons: 

1.  They  are  usually  made  of  refined,  devitalized  flour. 

2.  They  are  served  hot,  and  eaten  with  an  excess  of 
butter. 

3.  Soda  and  baking  powder  destroy  the  vitamines,  so 
even   though   whole   grain   were   used,   the   addition    of 
these  powders  would  tend  to  devitalize  the  grain,  with 
a  resulting  vitamineless  bread. 

4.  Baking  powders,  even  though  the  best,  leave  in  the 
bread   a  chemical   residue,   the  continuous  ingestion   of 
which  is  not  conducive  to  health. 

In  a  baking  powder  two  substances  are  combined,  one 
alkaline,  the  other  acid,  in  character.  The  alkaline  sub- 
stance is  soda,  the  acid  may  be  cream  of  tartar,  acid 
phosphate,  or  an  acid  salt  of  alum.  The  chemical  re- 
action between  the  acid  and  the  alkali  results  in  the 
formation  of  carbonic  acid  gas  (CO,)  and  a  salt.  The 
gas  passes  off  and  makes  the  bread  light,  the  salt  is 


BREADS   AND   CEREALS  113 

left  behind  as  a  residue  in  the  bread.  In  the  alum 
baking  powders  the  residue  is  particularly  unhealthful. 
Analysis  has  shown  that  a  cream  of  tartar  baking 
powder  leaves  about  70  per  cent  of  its  own  weight  in 
Rochelle  salts  as  a  residue  and  that  the  acid  phosphate 
leaves  about  35  per  cent  of  its  own  weight  in  sodium 
phosphate.  These  salts  are  all  saline  cathartics.  Ro- 
chelle salts  is  the  basic  element  of  a  Seidlitz  powder. 
From  the  United  States  Department  of  Agriculture  in 
Bulletin  No.  13,  we  receive  the  information  that  "  a  loaf 
of  bread  made  from  a  quart  of  flour  leavened  with 
cream  of  tartar  baking  powder  contains  forty-five  grains 
more  of  Rochelle  salts  than  is  contained  in  one  Seidlitz 
powder."  Also,  in  a  report  on  baking  powders  by  the 
Referee  Board  of  Consulting  Scientific  Experts,  ap- 
pointed by  the  United  States  Department  of  Agriculture, 
we  read  that  "it  is  wise  to  be  moderate  in  the  use  of 
foods  that  are  leavened  with  baking  powders."  Dr.  A. 
Warner  Shepard,  formerly  health  officer  in  Brooklyn, 
said :  "  I  have  not  the  slightest  doubt  that  the  mental 
and  physical  health  of  thousands  is  permanently  in- 
jured by  the  excessive  use  of  Rochelle  salts  in  bread  and 
other  forms  of  food  and  drink.  It  irritates  the  kidneys, 
bowels,  and  stomach  and  may  therefore  produce  most 
unfortunate  results." 

How  to  Use  Soda 

5.  Soda,  if  used  at  all,  should  be  used  with  an  acid 
in  exact  proportions,  so  that  there  may  be  no  excess  of 
alkali.  The  most  accurate  way  to  use  it  is  with  hydro- 
chloric acid  in  the  proportion  of  one  exactly  level  tea- 
spoon of  soda  to  80  minims  of  hydrochloric  acid.  In 
this  way  the  following  chemical  reaction  takes  place: 
HC1  (hydrochloric  acid)  +  NaHCO,  (soda)  =  NaCl  (salt) 
+  H,0  (water)  +  C02  (carbonic  acid  gas).  The  end 


114  THE    HOME   DIETITIAN 

products  are  simply  common  salt,  water,  and  carbonic 
gas  or  carbon  dioxide.  This  measurement,  however, 
must  be  exact.  Only  the  careful  housewife  should  use 
this  combination. 

We  quote  from  "  The  New  Cookery,"  by  Lenna  Frances 
Cooper :  "  It  is  advisable  when  using  hydrochloric  acid 
to  have  a  minim  glass,  which  can  be  purchased  for  a 
small  sum  at  any  drug  store.  One  perfectly  level  tea- 
spoon of  soda  is  neutralized  by  80  minims  of  hydro- 
chloric acid.  The  hydrochloric  acid  must  be  chemically 
pure  (marked  C.  P.)  and  in  the  concentrated  form. 
One  teaspoon  of  soda  and  80  minims  of  hydrochloric 
acid  are  equivalent  to  four  level  teaspoons  of  baking 
powder.  .  .  .  For  most  recipes,  one-half  teaspoon  of 
soda  and  40  minims  of  hydrochloric  acid  are  sufficient 
to  use  with  one  cup  of  flour."  (For  warm  breads  with- 
out baking  powder  see  Recipes,  Chapter  XXXI.) 

Very  satisfactory  breakfast  gems  may  be  made  with- 
out the  use  of  baking  powder  or  soda.  These  are  best 
made  with  whole-wheat  or  Graham  flour  and  are  light 
and  easy  of  digestion  (see  recipes  1  and  2). 

Cereals  as  Protein  Foods 

Cereals  are  very  useful  foods,  and  it  is  most  impor- 
tant that  their  comparative  values  be  understood  by  the 
housewife.  The  greater  part  of  the  protein  of  all  cereals 
is  found  in  the  pericarp  and  just  beneath  it,  so  any 
whole  cereal  is  comparatively  rich  in  protein.  Even  rice 
ceases  to  be  merely  a  starchy  food  when  not  deprived 
of  its  outer  covering.  The  tables  in  Chapter  VI  give 
the  approximate  protein  value  of  these  foods.  Whole 
or  cracked  wheat,  oatmeal,  and  whole  rice  contain  13 
to  18  per  cent  of  protein,  and  so  are  of  great  help  in  the 
making  up  of  the  necessary  daily  ration  of  nitrogenous 
food.  The  proteins  of  cereals,  which  are  often  incom- 


BREADS   AND   CEREALS  115 

plete,  need  to  be  supplemented  by  those  of  other  foods, 
as  milk,  eggs,  and  vegetables.  This  is  due  in  part  to  the 
fact  that  much  of  the  cereal  eaten  has  been  deprived 
of  important  proteins  in  the  outer  covering.  However, 
a  monotonous  diet  largely  of  cereals  or  of  a  single  cereal 
should  be  avoided.  (See  Chapter  VI.) 

To  Cook  Cereals 

Cereals  should  be  thoroughly  cooked,  preferably  in  a 
double  boiler  or  a  fireless  cooker.  The  length  of  time 
required  varies,  but  is  usually  two  and  one-half  to  six 
hours.  This  softens  the  outer  covering  and  prepares  the 
grain  for  easy  and  complete  digestion.  For  invalids  or 
for  small  children,  it  may  be  necessary  to  serve  cereals 
without  the  rough  elements,  but  the  prolonged  cooking 
has  put  into  solution  most  of  the  salts  and  vitamines  of 
the  outer  layer,  and  they  are  not  lost  to  a  great  extent 
when  only  the  harsh  exterior  is  strained  away.  Gruels, 
while  usually  considered  invalid  dishes,  make  a  nice 
variation  from  the  ordinary  breakfast  mush  and  may 
be  served  for  a  change  to  the  entire  family  for  break- 
fast or  as  an  evening  lunch.  (See  recipes  19,  20, 
Chapter  XXXI.) 

For  many,  the  dextrinized  cereals,  as  cornflakes,  wheat- 
flakes,  shredded  wheat,  etc.,  are  much  easier  of  digestion 
than  mushes,  which  are  often  soggy  and  swallowed  with- 
out sufficient  mastication.  Mushes,  when  served,  should 
be  prepared  in  such  a  way  as  to  render  them  dry  and 
flaky,  and  should  be  eaten  with  proper  regard  for  masti- 
cation. 

Rice  which  has  been  browned  in  the  oven  before 
cooking,  and  thus  its  starch  dextrinized,  makes,  when 
eaten  with  milk  or  cream,  a  very  agreeable  breakfast 
dish,  and  is  very  easily  digested. 


CHAPTER  XIV 
DAIRY  PRODUCTS 

DAIRY  products  have  ever  played  an  important  part 
in  the  nutrition  of  civilized  man,  and  a  shortage  of  these 
valuable  foods  must  always  be  regarded  as  a  calamity. 
From  this  source,  protein  that  has  been  elaborated  in 
the  animal  body  may  be  obtained,  lessening  markedly 
any  necessity  for  the  use  of  meat,  even  by  those  who 
depend  upon  animal  protein  for  their  supply  of  nitrog- 
enous food.  Associated  with  these  proteins,  are  min- 
eral salts  and  vitamines  which  add  greatly  to  their 
value.  Milk  is  an  important  source  of  the  fat-soluble 
vitamine,  and  egg  yolk  is  rich  in  iron.  Milk  and 
eggs,  being  produced  primarily  for  the  nutrition  of  the 
young  of  the  animal,  are  rich  in  those  things  necessary 
for  body  development  and  the  formation  of  new  tissue. 

Variation  Possible 

Not  only  is  milk  itself  of  value  for  children,  invalids, 
and  general  family  use,  but  the  products  derived  from 
it  make  possible  an  agreeable  and  helpful  variation  in 
the  form  in  which  the  protein  and  fat  of  milk  may  be 
served.  Those  who  do  not  care  for  milk  to  drink, 
usually  take  it  freely  as  used  in  cooking,  in  milk  soups, 
creamed  vegetables,  on  cereals,  in  custards,  puddings, 
desserts,  etc.  There  are  few  families  where  milk  in 
some  form  as  a  seasoning  and  constituent  of  various 
dishes  is  not  deemed  a  necessity.  As  buttermilk  and 
cottage  cheese,  the  protein  of  milk  may  be  served  in  a 
very  valuable  form,  and  one  most  easily  used  by  the 
body.  The  various  forms  of  cheese  are  used  the  world 
over,  and  by  many  are  considered  indispensable.  Butter, 

116 


DAIRY    PRODUCTS  117 

the  concentrated  fat  of  milk,  is  the  most  commonly  used 
of  free  fat,  and  few  would  be  able  to  eat  a  satisfactory 
meal  without  it. 

Eggs,  except  when  prices  are  prohibitive,  are  com- 
monly used  in  every  household,  and  are  served  in  so 
many  ways  that  they  may  be  used  daily  without  ap- 
parent monotony. 

Necessary  Considerations 

There  are  many  things  in  regard  to  these  important 
foods  to  which  the  attention  of  the  people  should  be 
continually  drawn :  The  purity  of  their  source,  with  pos- 
sibilities and  probabilities  for  contamination,  their  care 
before  reaching  the  consumer,  what  proportion  of  the 
daily  diet  they  can  well  make  up,  and  their  action  in 
the  digestive  tract,  with  resultant  effect  on  the  blood  and 
tissues.  These  and  more  should  receive  careful  consid- 
eration. 

Danger  of  Contamination 

Milk.1 —  The  source  of  milk  is  unfortunately  ever 
more  or  less  questionable  because  of  the  disease  of  ani- 
mals, the  great  care  necessary  to  avoid  contamination 
at  time  of  milking,  and  the  varying  length  of  time 
after  milking  that  elapses  before  it  is  taken  as  food.2 
Nature  intended  the  milk  to  pass  directly  from  the 
mother  to  her  young,  with  no  interval  affording  possi- 


1  See   also   Chapter   XXVIII. 

2  The  problem  of  our  milk  supply  is  expressed   by  Rosenau  as   follows :    "  Milk 
is  responsible  for  more  sickness  and  deaths  than  perhaps  all  other  foods  combined. 
There   are  several  reasons   for  this:    (1)    Bacteria   grow   well   in  milk;  therefore  a 
very  slight  infection  may  produce  widespread  and  serious  results  ;   (2)   of  all   food- 
stuffs, milk  is  the  most  difficult  to  obtain,  handle,  transport,  and  deliver  in  a  clean, 
fresh,   and   satisfactory   condition  ;    (3)    it  is  the  most  readily  decomposable  of  all 
our  foods  ;  (4)  finally,  milk  is  the  only  standard  article  of  diet  obtained  from  animal 
sources  consumed  in  its  raw  state." 

"  Fresh  milk  products  may  be  quite  as  dangerous  as  the  milk  from  which  they 
are  made,"  states  Rosenau ;  but  he  goes  on  to  say :  "  Milk  is  a  perfect  food  for  the 
suckling.  It  contains  all  the  essential  elements  of  a  well-balanced  diet  for  the 
adult,  and  at  prevailing  prices,  it  is  one  of  the  cheapest  of  the  standard  articles  of 
diet.  Furthermore,  it  is  readily  digestible  and  is  capable  of  a  great  variety  of 
modifications.  The  sanitarian,  therefore,  has  every  reason  to  encourage  the  use  of 
pure  milk  as  well  as  to  discourage  the  use  of  impure  milk."  —  "  Preventive  Medi- 
cine and  Hygiene,"  pp.  494,  495. 


118  THE    HOME   DIETITIAN 

bility  for  contamination.  Even  greater  danger  than  in 
the  disease  of  the  animal  itself,  lies  in  the  many  oppor- 
tunities for  contact  with  germs  and  impurities  at  the 
time  of  and  after  milking,  and  the  ease  with  which 
milk  undergoes  deterioration  and  putrefaction  after  it 
leaves  its  source.  The  milk,  even  from  a  tubercular  cow, 
may  be  of  very  good  quality,  providing  contamination 
from  the  discharges  of  this  cow  can  be  prevented  at 
time  of  milking.  It  is  said  that  infections  of  milk  al- 
ways occur  at  the  time  of  the  drawing  of  the  milk  from 
contact  with  extraneous  impurities,  e.  g.,  the  milker's 
hands,  the  hairs  and  exhalations  from  the  cow,  stable 
dust,  etc. 

However,  much  has  been  done  by  health  authorities 
to  minimize  the  dangers  of  impurity,  and  it  is  possible 
in  all  cities  to  obtain  milk  guaranteed  as  to  its  cleanli- 
ness. The  regrettable  feature  about  this  is  its  effect 
upon  the  price  of  good  milk,  making  it  in  many  cases 
almost  prohibitive. 

A  Friendly  Germ 

Possibilities  for  deterioration  of  milk  from  the  time 
of  milking  until  it  finally  reaches  the  consumer  are 
many,  and  again  make  it  difficult  to  know  that  milk  is 
in  good  condition,  except  in  the  case  of  certified  milk. 
Fortunately,  milk  sours  before  it  becomes  very  old,  and 
the  lactic  acid  formed  inhibits  the  action  of  putrefactive 
germs.  This  natural  protective  measure  ordinarily  pre- 
vents the  using  of  milk  in  which  putrefaction  has  set 
in.  However,  under  certain  conditions,  as  refrigeration, 
the  activity  of  the  lactic  acid  germ  may  be  inhibited 
and  the  milk  putrefy  before  it  sours,  accounting  for  the 
bad  taste,  known  to  housewives,  of  milk  which,  though 
not  sour,  has  stood  a  long  time  in  the  ice  box.  This 
milk  is  harmful,  sour  milk  is  not.  The  only  general  rule 


DAIRY   PRODUCTS  111) 

for  knowing  that  all  milk  used,  while  perhaps  not  clean, 
is  at  least  sterile  and  safe  to  use  for  all  purposes,  is  to 
boil  it. 

While  this  may  be  said  to  lessen  the  value  of  its  vita- 
mines,  these  can  be  supplied  by  other  foods  and  the 
milk  still  furnish  its  other  food  elements  unchanged. 
Diseases  spread  by  unclean  milk  are  many.  Among 
them  are  pus  infections,  typhoid  fever,  tuberculosis,  and 
scarlet  fever. 

Boiled   Milk 

As  it  is  also  known  that  the  boiling  of  milk  changes 
it  from  a  solid  food,  as  evidenced  by  the  large,  tough, 
leathery  curds  formed  in  the  stomach  from  raw  milk, 
to  a  relatively  liquid  food  in  which  the  curds  are  small 
and  easily  digested  (see  page  175),  it  makes  the  question 
of  the  advisability  of  boiling  milk,  especially  for  chil- 
dren, a  nondebatable  one.  Boiled  milk,  unless  in  sterile 
containers,  as  bottled  baby's  milk,  should  never  be  al- 
lowed to  stand  a  long  time  after  boiling,  but  should  be 
used  soon. 

All  animal  protein  is  more  or  less  susceptible  to  putre- 
faction in  the  digestive  tract.  The  using  of  milk  which 
is  fresh  and  as  nearly  sterile  as  possible,  or  in  its  lac- 
tic acid  form,  as  cottage  cheese  or  buttermilk,  greatly 
lessens  the  probability  of  putrefactive  processes  in  the 
alimentary  canal.  It  is  very  important  that  there  should 
be  included  in  the  diet  a  goodly  amount  of  such  foods  as 
fruit  and  green  vegetables,  which  will  facilitate  intes- 
tinal activity  and  thus  prevent  conditions  of  stagnation 
and  putrefaction. 

Stale  Milk 

Pasteurizing  milk,  or  heating  it  to  a  temperature  of 
140°  F.,  kills  the  disease-producing  germs  and  postpones 
souring.  It  does  not,  however,  to  the  same  degree  pre- 
vent putrefaction. 


120  THE    HOME   DIETITIAN 

So  it  is  possible  for  the  milk  to  deteriorate  greatly, 
so  much  so  that  putrefactive  processes  may  set  in  be- 
fore it  sours,  just  as  in  refrigeration.  Pasteurization, 
while  in  many  ways  beneficial,  has  too  often  meant  stale 
rather  than  fresh  milk.  Raw  milk,  obtained  as  fresh 
as  possible  and  boiled  before  using,  is,  in  the  author's 
opinion,  to  be  preferred  to  Pasteurized  milk.  Evapo- 
rated milk  may  be  used  in  cooking  if  fresh  foods  are 
used  freely.  It  should  be  remembered  that  it  is  a  de- 
vitalized food,  and  should  never  be  depended  upon  to 
take  the  place  of  fresh  milk. 

How  Much  Milk? 

The  amount  of  milk  that  can  be  used  by  different  in- 
dividuals varies  greatly.  It  depends  upon  the  form  in 
which  it  is  taken  and  the  amount  of  other  protein  food 
in  the  diet.  If  meat  is  included,  much  less  milk  is 
needed.  For  vegetarians,  milk  affords  a  valuable  means 
of  furnishing  the  concentration  of  protein  often  nec- 
essary to  balance  the  excessive  amount  of  concentrated 
energy  food  taken.  When  it  is  found  that  the  protein 
ration  falls  short  of  the  necessary  200  or  250  calories, 
it  can  easily  be  brought  up  to  normal  by  the  use  of 
milk  protein  in  some  form;  as  milk,  buttermilk,  or 
cottage  cheese.  Good  cottage  cheese  is  one  of  the  best 
forms  in  which  milk  protein  can  be  taken,  and  is  usu- 
ally well  borne  even  by  those  having  a  weak  digestion. 
Cheese  is  difficult  of  digestion,  and  may  well  be  eaten 
sparingly,  if  at  all. 

Butter  is  of  value  because  of  its  food  concentration 
and  its  content  of  fat-soluble  vitamine.  However,  much 
more  butter  is  eaten  by  nearly  every  one  than  should  be. 
In  the  amounts  in  which  it  is  eaten  it  helps  to  increase 
the  excess  of  fat  eaten  by  the  American  people,  and  as 
an  excess  of  free  fat,  is  often  a  hindrance  to  digestion. 
(See  Chapter  VII.)  Withal,  it  tends  to  partake  of  the 


DAIRY   PRODUCTS  121 

disadvantages  of  contamination  to  which  all  animal  food 
is  liable,  and  being  rather  unstable,  it  easily  becomes 
rancid,  especially  when  subjected  to  heat. 

How  to  Obtain  Fat-Soluble  A. 

These  facts  should  be  remembered,  and  butter  ob- 
tained in  as  fresh  and  clean  a  condition  as  possible.  It 
should  be  used,  as  all  concentrated  foods,  in  moderation, 
and  better  not  at  all  in  cooking.  Much  more  butter  is 
given  to  children  than  necessary  or  advisable.  It  is 
much  better  that  they  obtain  their  butter  fat,  with  its 
fat-soluble  A,  in  the  milk  itself,  the  food  value  of  which 
is  50  per  cent  fat.  Or,  if  necessary,  in  added  cream. 
The  vitamine  value  of  their  milk  should  be  supplemented 
by  the  high  vitamine  content  of  green  vegetables  and 
fruits,  especially  orange  juice  and  tomato.  These  vege- 
tables and  fruits  also  increase  intestinal  activity,  thus 
combating  the  tendency  of  milk  to  favor  intestinal  putre- 
factive processes.  It  is  not  the  butter  that  children 
need  particularly,  but  the  vitamine  that  it  contains,  and 
if  a  sufficient  supply  of  these  vitamines  can  be  secured 
without  butter,  there  can  be  no  advantage  in  depending 
upon  butter  for  a  greater  supply.  Speaking  of  experi- 
mental studies  along  these  lines,  an  editorial  in  the 
Journal  of  the  American  Medical  Association  of  April 
12,  1914,  says:  "It  is  through  such  laborious  studies, 
in  which  American  physiologists  have  been  conspicuous 
pioneers,  that  the  danger  of  identifying  certain  butter 
substances  with  butter  has  been  averted." 
A  Source  of  Iron 

Eggs  are  of  great  value,  first  for  the  complete  protein 
of  the  egg  white;  second,  for  the  iron  and  vitamine 
content  of  the  yolk.  Egg  protein,  as  that  of  milk,  is 
often  a  great  help  in  balancing  the  diet  of  one  whose 
daily  ration  is  top-heavy  in  energy  food  and  low  in 
protein. 


122  THE    HOME   DIETITIAN 

A  Protective  Combination 

Eggs  are  digested  with  ease  in  the  stomach.  Their 
disadvantage  lies  in  the  fact  that  they  tend  to  favor 
intestinal  putrefaction;  for  this  reason,  their  reputation 
for  producing  biliousness.  But  combined  in  a  properly 
planned  diet  and  eaten  in  moderation,  they  need  not  do 
this.  Eaten  in  excess,  they  tend  to  produce  the  results 
that  follow  an  excess  of  protein  in  any  form.  One  in- 
cluding in  one's  diet  animal  proteins  of  any  kind,  cannot 
permit  to  any  degree  a  condition  of  intestinal  stagnation, 
because  of  the  putrefactive  conditions  to  which  animal 
protein  is  ever  subject.  For  this  reason  the  successful 
use  of  animal  proteins  in  the  diet  depends  upon  their 
being  combined  with  a  large  amount  of  fresh  fruits  and 
green  vegetables,  both  of  these  tending  to  combat  the 
putrefactive  tendency  of  the  protein  food.  Children  who 
can  have  plenty  of  milk  are  just  as  well  off  without  eggs, 
as  the  simpler,  less  stimulating  diet  may  be  considered 
better  for  them. 

Eggs,  as  well  as  milk,  should  of  course  be  obtained  as 
fresh  as  possible,  and  from  hens  that  are  clean  and  well 
kept.  Not  only  is  the  purity  of  the  egg  affected  by  the 
condition  of  the  hen  itself,  but  also  by  contact  after  the 
egg  is  laid.  The  shell  being  porous,  impurities  are  soon 
absorbed.  So  it  is  a  great  advantage  when  eggs  can 
be  gathered  as  soon  as  laid  and  washed  before  being 
put  away. 

Eggs  in  What  Form? 

It  matters  little  in  what  form  eggs  are  served,  soft, 
medium,  or  hard  boiled,  poached,  or  scrambled,  or  in 
the  form  of  an  omelet.  The  fried  egg  is  rather  indi- 
gestible, as  are  all  fried  foods.  A  hard-boiled  egg,  if 
masticated  well,  is  quite  as  digestible  as  any  other.  One 
of  the  best  ways  in  which  to  prepare  eggs  is  to  boil 


DAIRY   PRODUCTS  123 

them  twenty  to  thirty  minutes,  or  until  the  yolk  is 
mealy.  Egg  yolks  prepared  in  this  way  may  be  a  valu- 
able source  of  iron  and  vitamines  for  children  and  invalids. 

There  is  not  the  advantage  in  raw  eggs  once  ascribed 
to  them.  Experiments  have  shown  that  cooked  eggs  are 
more  easily  digested  than  raw,  unless  the  raw  egg  is 
thoroughly  beaten,  so  that  the  tenacious  white  is  thor- 
oughly divided.  The  beaten  egg  added  to  gruels,  soups, 
or  served  as  fruit  eggnog  (see  recipe  110)  is  often  of 
advantage  in  the  feeding  of  the  sick,  and,  served  with 
fruit,  as  prune  or  apple  whip,  etc.,  helps  in  making 
pleasing  and  healthful  desserts. 

Not  altogether  so  healthful  as  has  been  supposed  are 
desserts  in  which  milk,  eggs,  and  sugar  are  combined. 
Intestinal  fermentation  and  putefaction  are  in  many 
cases  favored  by  this  combination. 

Again  we  would  urge,  that  if  one  wishes  to  combat  the 
digestive  disadvantages  of  a  diet  including  animal  pro- 
tein, one  should  realize  the  importance  of  a  free  use  of 
those  foods  which  will  make  impossible  any  abnormal 
delay  in  the  passing  of  these  animal  proteins  through 
the  digestive  canal.  Too  often  an  excess  of  animal  pro- 
tein is  taken  under  conditions  of  liver  torpidity  and 
intestinal  sluggishness,  which  furnish  a  most  fertile  field 
for  the  growth  of  the  putrefactive  bacteria  so  prone  to 
act  upon  protein  foods.  Because  of  the  delay  in  diges- 
tion, there  is  ample  time  for  these  putrefactive  proc- 
esses to  be  carried  to  the  point  of  extreme  toxin  forma- 
tion with  harmful  systemic  effects. 

With  a  free  amount  of  fruit  and  vegetables,  this 
tendency  may  in  most  cases  be  largely  overcome, 


CHAPTER  XV 
FLESH  FOOD:  IS  IT  A  DIETARY  ESSENTIAL? 

Discussion  I  —  Desire 

A  VEGETARIAN  was  asked  the  question,  "  Why  do  you 
not  eat  meat?"  His  reply  was,  "  Because  I  no  longer 
have  any  desire  for  it;"  and  he  added,  "I  turn  with 
aversion  from  the  thought  of  partaking  of  it,  and  were 
it  not  for  the  occasional  sight  of  some  one  enjoying 
heartily  his  meaty  viand,  I  might  almost  forget  that 
others  are  different  from  myself  in  this  respect  or  that 
meat  is  served  as  an  article  of  food." 

This  vegetarian  had  almost  forgotten  just  why  he  did 
not  eat  meat.  It  wasn't  that  the  doctor  had  said  he 
shouldn't,  or  that  he  couldn't  afford  it;  his  first  thought 
in  answer  to  the  q'uestion  was,  "  I  don't  want  it." 

The  reason  he  gave  for  the  fleshless  diet  is  a  very 
important  one;  for,  unless  one  can  reach  such  a  state 
of  mind,  one's  vegetarianism  is  liable  to  be  a  failure. 
And,  after  all,  there  are  very  few  of  us  who  will  resist 
for  an  indefinite  period  a  craving  for  some  article  of 
food  or  drink,  no  matter  what  the  theory  or  how  great 
the  determination;  either  the  desire  abates  and  finally 
flees,  or  we  drift  back  into  the  old  habit  and  thus  sat- 
isfy the  clamor  of  appetite's  demands. 

Again,  who  can  say  that  an  insatiable  craving  that 
persists  in  spite  of  time  and  determination,  is  anything 
less  than  a  physiologic  demand  for  some  needed  element 
or  combination  of  which  the  body  is  being  deprived? 
Today,  when  meat  is  the  most  expensive  of  foods,  there 
are  few  who  would  not  be  more  than  willing  to  omit  it 
from  their  bill  of  fare,  could  they  feel  satisfied  and  well 
nourished  without  it. 
124 


FLESH    FOOD  125 

Habit  and  Education 

Our  gustatory  likes  and  dislikes  are  the  result  of  two 
things :  First,  an  expression  in  our  consciousness  of  body 
needs;  second,  habit  or  education.  A  change  in  our 
mode  of  eating  must  not  fail  to  guarantee  to  the  body 
all  food  essentials.  Habit  and  education,  however,  often 
require  readjustment.  This  necessitates  a  knowledge 
of  why  the  change  is  being  made  and  the  right  mental 
attitude  on  the  part  of  the  individual.  With  body  food 
requirements  satisfied  and  intelligent  mental  co-opera- 
tion, re-education  becomes  a  simple  matter. 

In  many  ways,  eating  is  largely  a  matter  of  habit. 
The  tribes  of  Central  Africa  eat  their  pudding  of  mashed 
ants  with  as  much  relish  as  we  our  calves'  brains  or 
pickled  pigs'  feet.  But  few  of  us  would  partake  with 
very  much  enthusiasm  of  our  favorite  meat  dish,  with 
all  its  uncertainties,  had  not  habit  accustomed  our  minds 
to  the  thought. 

Just  now  I  think  of  a  rosy-cheeked  lad  of  ten,  who, 
having  never  tasted  meat,  stares  with  an  expression  of 
abhorrence  and  absolute  lack  of  understanding  upon  the 
rare  occasion  of  seeing  others  indulge  with  zest  in 
the  wing  of  a  chicken  or  a  juicy  beefsteak.  But  rules, 
theories,  our  better  knowledge,  even  our  sense  of  es- 
thetics, often  avail  little  as  against  habit,  custom,  and 
appetite's  clamorous  appeal.  And  so  I  say  again  that 
the  reason  given  above  is  of  great  importance  and  per- 
haps the  only  one  that  will  hold  good  in  the  last  analysis. 

Re-education 

But  how  may  such  a  mental  attitude  be  acquired? 
By  re-education  and  a  satisfactory  alternative  in  the  way 
of  a  sense  of  well-being  and  complete  nutrition  on  a 
diet  which  does  not  include  flesh  food  — "  if  there  be 
first  a  willing  mind."  The  number  of  vegetarians  is 


126  THE    HOME   DIETITIAN 

increasing,  and  there  are  many  who  have  long  since 
reached  the  period  in  their  physical  existence  where 
flesh  food  no  longer  finds  a  place  on  their  table  or  in 
their  daily  dietary.  Many  of  these  are  contented,  well 
nourished,  and  splendid  physical  specimens,  and  of  the 
same  mental  state  as  the  vegetarian  quoted.  The 
thought  is  growing  that  the  American  people  eat  far 
too  much  meat,  and  that  the  ideas  of  the  people  are 
already  being  greatly  modified  as  to  the  desirability  of 
this  class  of  food. 

Discussion   II  —  Need 

Scientific  investigation  has  shown  quite  conclusively 
that  body  needs  can  well  be  supplied  without  the  use  of 
meat.  Says  McCollum,  of  Johns  Hopkins,  after  experi- 
mental work  covering  a  period  of  years :  "  Lacto-vege- 
tarianism  [a  vegetarian  diet  including  milk]  ...  is, 
when  the  diet  is  properly  planned,  the  most  highly  sat- 
isfactory plan  which  can  be  adopted  in  the  nutrition  of 
man."  —  "  The  Newer  Knowledge  of  Nutrition,"  p.  52. 

The  food  principles  of  a  complete  diet  are:  carbohy- 
drates (or  starches  and  sugar),  fats,  protein,  mineral 
matter  (or  salts),  vitamines,  cellulose,  and  water.  The 
first  two  are  heat  and  energy  foods;  the  second  two  are 
building  material  for  the  body;  the  fifth  contains  the 
vital  elements  found  in  fresh  and  raw  foods,  the  pres- 
ence of  which  makes  it  possible  for  the  body  to  conduct 
its  life  processes;  the  sixth,  passing  through  the  di- 
gestive tract,  furnishes  necessary  bulk;  the  seventh, 
as  solvent,  diluent,  and  conductor,  holds  an  important 
place. 

Quality  Versus  Quantity 

It  is  of  great  importance  that  these  food  elements  be 
supplied  to  the  body  in  proper  amounts  and  proportions, 
but  it  is  quite  as  important  that  quality  as  well  as 


FLESH    FOOD  127 

quantity  be  considered.  Especially  is  this  true  of  ni- 
trogenous foods.  The  structure  of  the  proteins  is  more 
complex  than  that  of  any  of  the  other  food  classes,  and 
a  complete  protein  is  said  to  contain  some  eighteen  ni- 
trogenous combinations,  called  amino  acids,  and  often 
likened  to  "  building  stones."  In  order  to  build  the 
many  and  varied  body  tissues,  the  protein  part  of  our 
food  must  supply  all  of  the  eighteen  building  stones. 
A  protein  that  lacks  in  any  of  these  is  said  to  be  in- 
complete. It  is  then  of  greatest  importance  that  we 
know  where  complete  proteins  are  found,  in  order  that 
our  food  may  contain  all  that  is  necessary  to  keep  the 
body  in  the  best  of  repair. 

The  value  of  meat  as  a  food  lies  in  the  protein  which 
it  supplies.  These  proteins,  being  in  the  form  of  the 
actual  muscle  and  tissue  of  the  animal,  are  complete  in 
that  they  contain  all  necessary  protein  elements.  But 
meat  cannot  be  depended  upon  to  supply  food  elements 
other  than  protein.  It  supplies  energy  food  only  in  so 
far  as  it  contains  fat.  To  insure  vitamines  it  should 
be  eaten  raw,  with  a  large  quantity  of  the  blood.  To 
furnish  a  sufficient  amount  of  mineral  matter  it  would 
be  necessary  to  eat  the  bones. 

Blood  and  Bones 

Quoting  again  from  McCollum :  "  The  pronounced  de- 
ficiencies of  muscle  tissue  [lean  meat]  as  a  foodstuff, 
naturally  suggests  the  question  of  the  reason  for  the 
success  of  the  nutrition  of  the  strictly  carnivorous  ani- 
mals. The  explanation  is  found  in  the  order  in  which 
such  creatures  select  the  parts  of  the  carcasses  of  their 
prey.  The  larger  carnivora,  after  striking  down  an  ani- 
mal, immediately  open  the  large  veins  of  the  neck  and 
suck  blood  as  long  as  it  flows.  Their  second  choice  of 
tissues  is  the  liver,  and  following  this  the  other  glandu- 


128  THE    HOME   DIETITIAN 

lar  organs.  Muscle  tissue  is  only  eaten  after  these  have 
been  consumed.  With  such  a  selection  the  animal  se- 
cures everything  which  it  needs  for  its  nutrition  except 
a  sufficient  amount  of  calcium,  and  this  is  obtained 
through  gnawing  off  the  softer  parts  of  the  extremities 
of  the  bones."  —  "  The  Newer  Knowledge  of  Nutrition," 
pp.  78,  79. 

Protein  Letters 

This  plan  hardly  being  feasible  for  any  of  us,  we  find 
ourselves,  vegetarians  or  otherwise,  dependent  upon  the 
vegetable  kingdom  and  on  foods  other  than  meat  for  a 
large  part  of  our  food  supply.  As  has  been  said,  meat 
contains  all  necessary  protein,  but  during  the  process  of 
digestion,  the  meat  fiber  must  become  disintegrated  and 
the  protein  elements  dissolved  out  and  reduced  to  the 
before-mentioned  elemental  substances  just  the  same  as 
if  the  protein  had  been  taken  in  some  other  form.  After 
absorption  these  amino  acids,  or  "  building  stones,"  or 
"  letters  of  the  protein  alphabet,"  as  they  are  sometimes 
called,  are  put  together  again  to  form  the  different  kinds 
of  body  tissue,  or  to  form,  if  you  please,  the  complete 
epistle  of  the  human  organism.  (See  Chapter  VI.)  The 
origin  of  these  amino  acids,  whether  animal  or  vege- 
table, matters  not.  After  being  separated  by  digestion, 
they  stand  side  by  side  unrecognizable  as  to  source.  The 
only  question  of  importance  is,  Is  there  an  adequate 
supply  of  each  of  the  necessary  eighteen  "  building 
stones"?  or  is  there  a  sufficient  number  of  each  of  the 
protein  letters  so  that  the  body  epistle  may  be  properly 
written  ? 

Therefore,  if  we  can  be  certain  that  our  diet  contains 
all  essential  protein  material,  both  as  to  quality  and  as 
to  quantity,  we  can  reasonably  draw  the  conclusion  that, 
whether  or  not  it  is  meat  when  we  partake  of  it,  is  of 


FLESH    FOOD  129 

little  consequence.  And  it  is  evident  that,  if  a  diet  can 
be  devised  apart  from  meat  that  will  supply  to  the  sys- 
tem a  sufficient  amount  of  complete  proteins,  meat  will 
be  proved  unnecessary. 

Value   of   Vegetable    Proteins 

This  has  indeed  been  very  conclusively  shown.  Stu- 
dents of  nutrition  now  tell  us  that  without  a  doubt  it 
is  quite  possible  to  obtain  sufficient  and  complete  pro- 
teins without  the  use  of  flesh  foods.  Experimental  evi- 
dence abounds  to  show  that  the  proteins  of  milk,  eggs, 
and  of  leafy  vegetables  as  well,  are  of  at  least  as  good 
a  quality  as  those  of  meat,  and  that  in  a  large  number  of 
cases  they  are  more  readily  utilized  by  the  body.  Milk 
and  the  leafy  vegetables  stand  side  by  side  as  so-called 
"  protective  foods  "  in  that  they  insure  an  easily  avail- 
able supply  of  complete  proteins  as  well  as  an  ample 
amount  of  vitamines  and  mineral  salts.  These,  com- 
bined with  the  proteins  of  legumes  and  cereals,  make  it 
possible  to  supply  the  necessary  quality  as  well  as  the 
required  quantity. 

Discussion  III  —  Economy 

The  question  of  economy,  both  personal  and  for  the 
nation  at  large,  leads  us  to  question  carefully  the  ad- 
visability of  the  use  of  so  large  an  amount  of  flesh  food 
as  is  yearly  consumed  by  the  American  people.  Our 
recent  food  conservation  campaign  has  taught  us  the 
extravagance  of  feeding  so  much  of  food  grains  to  ani- 
mals and  then  eating  the  animal.  Dairy  products  are 
much  more  vitally  necessary  than  is  meat.  Meat  can  in 
no  way  be  said  to  take  the  place  of  milk  as  a  food.  A 
shortage  of  milk  is  ever  a  disaster.  "  A  well-nourished 
cow,  during  a  year  will  give  in  the  form  of  milk  as 
much  protein  and  two  and  a  half  times  as  many  calories 
as  are  contained  in  her  own  body."  What  a  shame,  then, 


130  THE    HOME   DIETITIAN 

to  kill  the  cow  for  food  and  stop  the  supply  of  milk 
which  in  another  year's  time  would  more  than  equal  the 
food  value  of  her  own  body,  with  still  the  source  of  sup- 
ply for  other  years  to  come. 

Dr.  Graham  Lusk  says :  "  Everything  should  be  done 
to  conserve  our  herds  of  cows  for  the  increased  supply 
of  whole  milk."  And  again:  "Let  no  family  (of  five 
persons)  buy  meat  until  it  has  bought  three  quarts  of 
milk,  the  cheapest  protein  food."  In  general,  twice  as 
much  meat  is  used  as  is  right;  for  to  produce  meat, 
requires  much  fodder  which  might  better  be  used  for 
milk  production."--  Address  given  at  the  National  Mu- 
seum, Washington,  D.  C.,  Aug.  30,  1917. 

Why  Choose  Second-hand  Foods? 

The  food  emergency  arising  as  the  result  of  the  war, 
was  met  in  perhaps  the  most  satisfactory  way  by  the 
Danes.  Their  plan  consisted  in  reserving  the  available 
cereals,  as  well  as  a  large  proportion  of  the  potatoes 
grown  in  Denmark,  for  the  people  themselves,  instead  of 
feeding  them  to  the  domestic  animals,  particularly  cat- 
tle and  hogs.  This  soon  greatly  reduced  the  supply  of 
meat,  and  the  Danish  people  thrived  on  the  diet  of  vege- 
tables and  dairy  products  thus  saved  to  them.  When 
it  has  been  conclusively  shown  that  the  human  organism 
can  utilize  vegetable  products  first  hand,  what  is  the 
advantage,  I  ask,  of  the  added  expense  resulting  from 
the  feeding  of  these  natural  foods,  first  to  animals,  and 
then  our  taking  them  second  hand,  as  it  were,  through 
the  flesh  of  the  animal? 

The  war,  with  its  demands  for  rigid  economy,  is  over, 
but  the  question  of  feeding  the  world  remains  a  live 
one  and  the  high  cost  of  living  a  personal  problem  with 
us  all.  Economy  consists  in  spending  "  not  less,  but 
more  wisely,"  and  may  not  the  decision  to  derive  our 


FLESH   FOOD  131 

protein  food  from  a  less  expensive  source  be  one  prac- 
tical way  of  helping  to  solve  the  problem. 

Some  may  say,  "  But  is  not  milk  expensive,  and  al- 
most as  much  so  as  meat?  "  Yes,  too  true,  but  milk 
furnishes  us,  besides  its  protein,  many  things  that  meat 
does  not.  We  get  "  more  for  our  money,"  and  a  re- 
duction in  the  use  of  meat  would  help  greatly  in  lessen- 
ing the  cost  of  milk.  Then,  too,  few  realize  the  great 
value  of  leafy  vegetables  as  regards  their  complete  pro- 
teins, and  that  an  intelligent  use  of  these  will  help  to 
supplement  the  somewhat  incomplete  proteins  of  cereals 
and  legumes.  Now  is  the  time  to  know  foods  and  their 
values. 

Discussion  IV  —  Purity 

So  far  so  good.  We  have  found  that  meat  may  become 
unnecessary  from  the  standpoint  of  gastronomic  desire 
or  of  body  need ;  in  these  days  of  the  high  cost  of  living 
we  find  so  many  other  ways  of  spending  our  money  that 
why  need  the  question  be  considered  further?  How- 
ever, for  the  sake  of  those  who,  because  of  education, 
habit,  and  cultivated  taste  are  being  "  convinced  against 
their  will,"  we  will  proceed  still  further: 

Two  classes  of  foodstuffs  are  available  to  every  one 
of  us:  First,  that  which  is  clean,  pure,  and  wholesome, 
at  the  same  time  wholly  adequate  for  body  needs ;  second, 
that  which  is  impure  and  tainted, —  food,  that  while  sup- 
plying valuable  food  principles,  supplies  them  in  combi- 
nation with  impurities  of  various  kinds,  introducing  into 
the  system,  along  with  the  food,  poisons  and  filth. 
These  are  a  great  handicap  to  a  digestive  tract  in  its 
effort  to  prepare  food  for  absorption;  to  a  liver,  doing 
its  utmost  to  filter  out  from  the  food-ladened  blood  all 
poisons  absorbed  from  the  digestive  tract;  and  to  the 
circulating  fluids  of  the  body,  in  their  effort  to  keep 
themselves  free  from  impurities  as  they  carry  nutri- 


132  THE    HOME   DIETITIAN 

ment  to  the  cells  and  tissues.  When  possible  to  obtain 
food  that  is  pure  and  uncontaminated,  why  should  there 
be  any  hesitancy  in  the  choice? 

Clean  and  Unclean 

The  time  was  when  flesh  food  was  divided  into  two 
classes,  "  clean  and  unclean."  Today  it  is  no  longer 
possible  to  do  this;  animals,  fish,  and  fowl  are  alike 
tainted  with  disease,  disease  germs,  and  poisons.  A 
large  amount  of  meat  put  out  for  food  has  been  taken 
from  carcasses  parts  of  which  have  been  rejected  be- 
cause of  disease.  According  to  statistics,  where  one 
carcass  is  rejected  entire,  three  to  ten  are  rejected  in 
part,  the  other  portion  being  put  on  the  market. 

Post-mortem  condemnations  for  one  year  in  the  United 
States  were: 

Rejected  Entire  Rejected  in  Part 

Cattle   35,103  99,739 

Swine 86,912  799,300 

Sheep    10,714  170 

Goats    82  1 

Note  the  number  of  carcasses  rejected  only  in  part, 
indicating  that  the  remaining  portions  were  retained  as 
fit  for  food. 

Inflammations,  abscess,  tumor,  or  tuberculosis,  in 
one  part  of  the  animal's  body,  is  not  necessarily  con- 
sidered sufficient  reason  for  the  rejection  of  the  entire 
carcass. 

And  again,  "  Of  some  five  hundred  livers  in  one  lot, 
only  forty  were,  according  to  the  testimony  of  one  in- 
spector, considered  good  enough  for  export.  The  rest 
were  reserved  for  home  consumption."  These  things  are 
to  be  said  of  meats  most  carefully  inspected.  In  out- 
of-the-way  places  and  smaller,  carelessly  inspected 
slaughterhouses,  it  may  be  left  to  the  imagination  as 


FLESH   FOOD  133 

to  the  character  of  the  meat  sold.     We  quote  the  fol- 
lowing : 

Slaughterhouses 

"  At  nearly  all  slaughterhouses  inspected,  foul,  nause- 
ating odors  filled  the  air  for  yards  around.  Swarms  of 
flies  filled  the  air  and  the  buildings  and  covered  the 
carcasses  which  were  hung  up  to  cool.  Beneath  the 
houses  was  to  be  found  a  thin  mud,  or  a  mixture  of 
blood  and  earth,  churned  by  hogs,  which  were  kept 
to  feed  upon  the  offal.  Maggots  frequently  existed  in 
numbers  so  great  as  to  cause  a  visible  movement  in  the 
mud.  Water  for  washing  the  meat  was  frequently  drawn 
from  dug  wells  which  received  seepage  of  the  slaughter- 
house yards,  or  the  water  was  taken  from  the  adjoining 
streams,  to  which  the  hogs  had  access.  Dilapidated 
buildings  were  the  usual  thing,  and  always  the  most  re- 
pulsive surroundings  and  odors  existed."  —Slaughter- 
house Inspector  of  Indiana.  Government  Bulletin. 

Many  frankfurters  and  Bolognas  are  said  to  consist 
largely  of  horse  meat,  immature  veal,  and  decrepit  and 
sick  cows,  tuberculous  and  otherwise.  Prepared  sausage 
casings  have  been  found  to  contain  about  five  grams 
(about  a  teaspoonful)  of  excrement  per  meter. 

Pork 

Pork,  of  all  meats,  is  especially  unfit  for  food.  Filth 
is  the  hog's  natural  element,  and  it  is  impossible  for  its 
flesh  to  be  wholesome.  Its  flesh  often  swarms  with 
parasites,  and  trichinosis  caused  by  the  eating  of 
incompletely  cooked  pork,  is  too  well  known  to  need 
discussion. 

Fish  and  Fowl 

Fish  may  become  contaminated  by  the  filth  on  which 
they  feed.  Having  come  in  contact  with  the  sewage  of 
large  cities,  they  may  pass  into  distant  waters  and  be 


134  THE    HOME   DIETITIAN 

caught  where  the  water  is  pure  and  fresh.  In  pur- 
chasing fish  from  the  market  it  is  impossible  to  know 
their  source.  It  is  a  very  common  occurrence  to  find 
fish  fresh  from  the  market  or  fish  wagon  with  worms 
crawling  out  of  their  flesh. 

Thirty  per  cent  of  oysters,  five  miles  from  sewer 
outlets,  contain  the  colon  bacillus,  a  germ  whose  habitat 
is  the  human  intestinal  tract. 

"  Not  long  ago  the  Metropolitan  Sewage  Commission 
of  New  York  and  the  Merchants'  Association  made  an 
exhaustive  investigation  of  waters  and  oyster  beds  sur- 
rounding New  York,  and  reported  the  harbor  to  be  one 
vast  cesspool,  foul  with  disease  germs  and  undissolved 
sewage  matter.  Two  million  oysters  were  taken  an- 
nually from  these  waters."  —  National  Food  Magazine. 

"  The  pernicious  practice  of  fattening  oysters  on  sew- 
age has  been  the  cause  of  untold  deaths  from  typhoid 
fever  in  the  past."  —  Roberts. 

Those  who  have  to  do  with  the  raising  of  chickens 
know  how  commonly  they  may  be  diseased,  and  that  in 
partaking  of  even  this  meat  a  risk  is  run  of  taking  that 
which  is  unwholesome  and  impure  because  of  disease. 

Animals  of  any  kind  may  be  apparently  well  and  yet 
have  disease  in  their  systems  and  be  killed  for  food  just 
before  the  symptoms  of  the  disease  manifest  themselves. 
It  is  absolutely  impossible  to  be  always  certain  that  any 
animal  at  the  time  of  its  slaughter  is  free  from  disease 
which  perhaps  has  not  yet  manifested  itself  outwardly. 

A  Wise  Provision 

Meat  as  ordinarily  prepared  and  eaten,  even  though 
from  healthy  animals,  can  hardly  be  considered  pure 
food.  Instructions  to  the  Israelites  controlling  their 
preparation  and  use  of  meat,  enjoined  them  not  to 
eat  the  blood:  Harrington  and  Richardson's  "  Practical 


FLESH    FOOD  135 

Hygiene  "  says :  "  The  Jewish  method  of  slaughtering 
is  regarded  by  many  as  far  superior  to  any  other.  Ac- 
cording to  Dembo,  it  is  most  rational  from  a  hygienic 
standpoint,  since  the  animal  is  bled  rapidly  and  com- 
pletely." So  meat,  if  eaten  at  all,  should  be  thoroughly 
cleansed  from  all  its  juices,  which,  for  many,  would  de- 
tract greatly  from  its  desirability. 

Egg  Tea 

When  meat  juices  are  eaten,  there  are  introduced  into 
the  organism  poisonous  wastes  which  would  have  been 
eliminated  through  the  kidneys  had  the  animal  lived. 
We  quote  the  following  from  Dr.  A.  L.  Benedict,  in  the 
Journal  of  the  American  Medical  Association:  "  A  meat 
broth  .  .  .  contains  salts,  extractives  which  are  mainly 
excrementitious,  and  a  little  gelatin,  as  well  as  some 
melted  fat,  although  the  last  is  often  skimmed  off  to 
make  the  broth  more  pleasant  and  palatable.  In  so  far 
as  protein  is  concerned,  a  meat  tea  made  by  boiling 
cannot  be  more  nourishing  than  egg  tea,  that  is  to  say, 
the  water  in  which  eggs  are  poached ;  or  in  plain  words, 
it  contains  no  protein  nourishment  at  all  and  is,  barring 
certain  qualitative  and  quantitative  differences,  of  the 
same  dietetic  value  as  urine." 

These  wastes  are  much  the  same  as  the  caffeine  of 
tea  and  coffee,  with  some  of  their  stimulating  action. 
So,  one  leaving  off  flesh  food  often  misses  this  stimu- 
lation and  thinks  he  must  have  meat  to  give  him 
strength.  These  wastes  impose  upon  the  body  processes 
great  handicap,  in  the  caring  for  and  elimination  of 
them,  in  addition  to  like  wastes  normally  present  as  a 
result  of  tissue  processes. 

Decomposition 

Putrefactive  processes  also  play  a  part  in  the  de- 
terioration of  flesh  food.  The  ever-present  germ  be- 


136  THE    HOME   DIETITIAN 

gins  its  work  upon  the  flesh  of  the  animal  as  soon  as 
life  is  extinct,  and  decomposition  begins  immediately. 
The  products  of  putrefaction  are  not  all  poisonous,  but 
very  often  deadly  poisons  are  formed;  and  poisoning 
produced  by  decayed  meat  and  fish  is  not  an  unknown 
occurrence.  This  form  of  poisoning  is  known  as  pto- 
maine poisoning,  ptomaines  being  organic  bases  result- 
ing from  the  activity  of  bacteria  on  nitrogenous  matter. 
These  ptomaines  may  be  formed,  after  the  meat  is  eaten, 
through  changes  occurring  in  the  intestines  as  a  result 
of  the  excess  of  protein  and  the  stagnation  in  the  bowel. 
However,  decomposition  has,  in  most  cases,  progressed 
to  a  great  extent  before  the  meat  is  eaten.  Often  meat 
is  not  considered  ready  to  eat  until  it  has  reached  a 
certain  stage  of  putrefaction  and  perhaps  is  ready  to 
fall  to  pieces. 

Ripe  Meat 

Food  Inspector  Dodge,  of  the  District  of  Columbia, 
testified  that  families  of  social  prominence  in  Washing- 
ton preferred  "  ripe  "  meat  because  it  was  more  tender. 
"  Many  savage  peoples  prefer  putrid  fish  and  meat,  and 
the  more  rotten  it  is,  the  greater  their  enjoyment  in  its 
consumption.  In  less  degree,  the  same  is  true  of  many 
of  the  most  enlightened  people,  who  prefer  game  when 
decomposition  is  fairly  well  advanced."  -Harrington 
and  Richardson's  "Practical  Hygiene,"  edition  1911, 
p.  66. 

In  however  good  condition  meat  may  be  taken,  it  is 
very  liable  to  putrefaction  in  the  intestinal  tract.  It 
has  been  estimated  by  competent  observers  that,  of  the 
flesh  food  eaten,  one  tenth  to  one  seventh  putrefies  or 
rots  in  the  intestine.  This  may  greatly  increase  a  tend- 
ency toward  intestinal  toxemia  or  auto-intoxication. 

As  our  imagination  becomes  active,  it  is  not  difficult 
to  imagine  a  state  of  mind  in  which  the  thought  of 


FLESH   FOOD  137 

meat  as  a  food  becomes  absolutely  distasteful,  with,  in- 
deed, a  sense  of  relief  when  it  is  established  beyond 
doubt  that  meat  is  in  no  way  necessary  for  food;  for 
it  is  from  the  esthetic  viewpoint  that  we  are  most 
easily  influenced,  perhaps,  in  spite  of  the  fact  that, 
theoretically  at  least,  we  are  desirous  of  maintaining 
ourselves  in  health,  and  of  avoiding  disease.  But  in 
order  that  the  discussion  of  our  subject  may  be  com- 
plete, we  will  continue  a  little  further. 

Discussion  V  —  Excess 

The  excess  of  protein  often  resulting  from  a  meat 
diet  may  be  a  factor  in  the  production  of  the  condition 
which  we  have  called  suboxidation  (see  Chapter  IV). 
The  metabolism  of  protein  results  in  the  formation  of 
a  solid  ash  (see  page  28),  and  when  too  much  protein 
is  eaten,  this  ash  may  become  excessive,  producing 
"  clinkers  "  which,  as  they  tend  to  clog  the  body  stove, 
help  to  produce  such  conditions  as  rheumatism,  gout, 
sciatica,  high  blood  pressure,  etc.  Under  these  condi- 
tions the  kidneys,  in  their  effort  to  eliminate  the  excess 
of  nitrogen  in  the  form  of  this  incompletely  oxidized 
ash,  are  overworked  and  often  become  diseased.  Pro- 
fessor Quine,  dean  of  the  Medical  Department  of  the 
University  of  Illinois,  said :  "  Where  one  man  dies  of 
Bright' s  disease  due  to  chronic  alcoholism,  fifty  men  die 
of  Bright's  disease  due  to  an  excess  of  protein  food, 
especially  meat." 

Meat  as  a  Fuel 

The  fires  of  the  system  must  burn  more  vigorously  in 
order  to  oxidize  protein,  and  protein  seems  to  stimulate 
this  vigorous  oxidation  which,  of  itself,  is  a  benefit. 
But  when  an  excess  of  protein  is  taken,  we  may  find 
the  body  fires  in  the  condition  expressed  as  follows  by 
Dr.  Hindhede,  the  great  Danish  dietetic  authority: 


138  THE    HOME    DIETITIAN 

"  Meat  is  a  fierce  burning  fuel,  but  it  seems  to  burn 
out  the  oven  itself  in  the  long  run." 

A  Physiological  Economy 

Says  Dr.  Winfield  Hall,  professor  of  physiology, 
Northwestern  University  Medical  School :  "  Body  weight, 
health,  strength,  mental  and  physical  vigor,  and  en- 
durance can  be  maintained  with  at  least  one  half  the 
protein  food  ordinarily  consumed.  A  kind  of  physio- 
logical economy  which,  however,  if  once  entered  upon 
intelligently  entails  no  hardship,  but  brings  with  it  an 
actual  betterment  in  health." 

Lest  a  few  may  still  doubt  as  to  the  necessity  for 
meat  in  the  diet,  we  will  give  the  following  quotations 
in  regard  to  experiments  which  have  been  conducted  for 
the  purpose  of  clearing  up  this  very  point: 

Physical  Superiority 

"  Comparative  experiments  on  seventeen  vegetarians 
and  twenty-five  meat  eaters  in  the  laboratory  of  the 
University  of  Brussels,  have  shown  little  difference  in 
strength  between  the  two  classes,  but  a  marked  su- 
periority of  the  vegetarians  in  point  of  endurance. 
The  average  superiority  was  53  per  cent.  The  vege- 
tarians recuperated  from  fatigue  more  quickly  than  the 
meat  eaters."  —  Irving  Fisher. 

"  Fourteen  meat  eaters  and  eight  vegetarians  started 
out  on  a  seventy-mile  walking  match.  All  the  vege- 
tarians reached  the  goal  in  splendid  condition,  the  first 
covering  the  distance  in  fourteen  and  a  quarter  hours. 
An  hour  after  the  last  vegetarian  came  in  the  first  meat 
eater  came  in,  and  he  was  completely  exhausted.  He 
was  also  the  last  meat  eater,  for  all  the  rest  had  dropped 
off  after  thirty  miles  of  endeavor."  -  Idem. 

Dr.  Graham  Lusk  says :  "  The  popular  idea  of  the 
necessity  of  meat  for  a  laboring  man  may  be  epitomized 


FLESH   FOOD  139 

in  the  statement :  '  A  strong  man  can  eat  more  meat 
than  a  weak  one,  hence  meat  makes  a  man  strong/ 
The  proposition  is  evidently  absurd."  —  Address  given 
at  the  National  Museum,  Washington,  D.  C.,  Aug.  30, 
1917. 

There  are  other  reasons  that  might  be  given  as  to  the 
advantage  of  a  fleshless  diet;  much  more  could  be 
written,  but  we  lack  time  and  space.  The  unpreju- 
diced individual  may  find  much  to  persuade  him  that 
a  well-balanced  vegetarian  diet  has  much  to  recom- 
mend it  over  that  of  one  including  meat.  All  that  most 
people  need  is  re-education  as  regards  eating,  and  they 
will  be  happier  and  live  longer.  Many  have  tried  veg- 
etarianism and  failed  —  not  because  meat  is  essential, 
but  because  they  have  not  understood  food  essentials 
and  how  they  should  be  supplied.  To  the  one  who 
adopts  the  fleshless  diet  intelligently  and  with  as  rea- 
sonable a  knowledge  of  how  to  feed  himself  as  he  would 
expect  to  have  in  regard  to  feeding  his  hens,  or  cows, 
were  he  raising  them,  will  be  added  health,  happiness, 
and  length  of  days,  with  keener  enjoyment  in  eating 
as  well. 


"  The  fleshless  diet  is  practical  and  rational. 
It  should  be  accepted  and  commended  by  those 
who  pursue  the  ideal  of  the  formation  and  edu- 
cation of  gentle,  intelligent,  artistic,  and  never- 
theless prolific,  vigorous,  and  active  races."- 
Gautier,  in  "  Diet  and  Dietetics,"  p.  413. 


CHAPTER  XVI 
CONDIMENTS 

A  TWOFOLD  purpose  is  accomplished  in  eating:  First, 
the  supplying  of  a  physiological  need;  second,  the  en- 
joyment resulting  from  the  partaking  of  pleasant  food. 

Physiologic  need  being  supplied,  hunger  disappears 
and  appetite  wanes,  but  humanity,  so  keen  to  surfeit 
itself  with  pleasure,  has  tended  to  tempt  the  fleeting 
appetite  with  foods  so  prepared  that  they  may  appeal 
to  the  palate  even  after  the  needs  of  the  body  are 
supplied. 

Taste  Buds 

This  having  been  for  so  long  the  tendency  of  man- 
kind, we  find  ourselves  caring  most  for  those  things 
artificially  and  excessively  seasoned,  and  so,  often  de- 
pend upon  the  seasoning  rather  than  upon  the  natural 
flavor.  In  fact,  few  have  taste  buds  l  so  sensitive  that 
they  are  able  fully  to  appreciate  the  exquisite  flavors 
of  the  foods  so  wonderfully  supplied  by  nature. 

It  has  been  said  that  given  any  article  capable  of 
disintegration  by  the  teeth,  plus  the  various  condi- 
ments and  seasonings  known  to  the  modern  chef,  a  dish 
fit  for  a  king  may  be  evolved.  So  with  peppers  and 
sauces,  with  frying  and  basting,  our  food  is  set  before 
us  in  such  a  form  that  it  is  often  impossible  for  us  to 
tell  of  what  we  are  eating. 

Eating  for  Drunkenness 

As  "  overflavoring  leads  to  overeating,"  the  custom 
of  serving  richly  and  highly  seasoned  food  undoubtedly 


1  Sensory   nerve   endings   on    the   tongue   and   palate   that   provide  the   sense   of 
taste. 

140 


CONDIMENTS  141 

has  much  to  do  with  the  too  prevalent  dietetic  sin  of 
eating  for  drunkenness  rather  than  strength.  To  re- 
educate our  sense  of  taste  that  it  might  be  normally 
sensitive  to  nature's  exquisite  flavors  would,  if  we  could 
but  realize  it,  give  us  the  keener  enjoyment  and  pre- 
vent the  suffering  of  penalties  for  the  breaking  of  nat- 
ural law. 

A  Protection 

The  mucous  lining  of  the  digestive  tract  has  two 
very  important  functions :  First,  to  secrete  the  digestive 
fluids;  second,  to  produce  mucus,  which  is  a  natural 
lubricant  and  protects  the  delicate  membrane  from  the 
mechanical  friction  of  food  itself  or  from  any  other 
irritation  which  might  enter  it  from  the  outside  world. 

Quantity  Rather  than  Quality 

Condiments,  such  as  mustard,  pepper,  vinegar,  etc., 
by  reason  of  their  irritating  effect,  produce  a  congestion 
of  the  mucous  membranes  with  which  they  come  in 
contact.  This  temporarily  increases  the  flow  of  diges- 
tive juice,  but  analysis  has  shown  that  the  character 
of  this  fluid  is  quite  different  from  that  produced  as 
the  result  of  the  presence  of  food  unassociated  with 
condiments.  An  analysis  of  the  salivary  secretions  fol- 
lowing the  introduction  into  the  mouth  of  peppered 
food,  shows  an  increase  in  the  quantity  but  a  lowering 
of  the  quality.  Though  there  is  more  saliva,  it  con- 
tains less  ptyalin  (the  active  digestive  principle)  and 
more  mucus.  Consequently  it  is  weak  in  digestive  power. 

Just  so  in  the  stomach  and  intestine;  and  as  the  re- 
sult of  repeated  irritations  of  this  kind,  the  little  cells 
whose  duty  it  is  to  secrete  mucus,  in  their  effort  to 
protect  against  an  ever-increasing  irritation,  secrete 
more  and  more  mucus  and  to  a  greater  or  less  degree 
crowd  out  the  cells  that  normally  secrete  digestive 


142  THE    HOME    DIETITIAN 

juices.  The  mucous  glands  increase  in  number  and 
size,  the  digestive  glands  grow  fewer,  the  mucous  mem- 
brane thickens,  becomes  calloused,  as  it  were,  until,  as 
the  months  and  years  go  by,  catarrh  of  the  stomach 
(or  bowel)  often  results,  with  a  "  corn  "  in  the  stom- 
ach instead  of  on  the  foot.  The  cause  is  the  same :  a 
long-continued  abnormal  irritation  and  an  effort  on  the 
part  of  the  epithelial  wall  to  protect  itself  —  one  is 
analogous  to  the  other,  but  the  first  is  far  more  disas- 
trous and  as  difficult  to  cure. 

But  the  deleterious  effect  of  condiments  does  not  stop 
here:  the  irritants  are  absorbed,  enter  the  portal  sys- 
tem, produce  chronic  congestion  of  the  liver,  and,  in 
their  elimination  through  the  kidneys,  cause  the  same 
irritation  in  those  organs,  with  consequent  thickening 
and  scar  tissue  formation.  Especially  objectionable  are 
those  articles  hardened  and  preserved  in  brine  and  vin- 
egar as  pickles.  As  the  vinegar  preserves  the  cucum- 
ber, so  do  these  irritants  toughen  and  pickle  the  tissues, 
and  in  addition  to  the  irritation  of  the  condiment  is 
added  the  indigestibility  of  the  toughened  article  of 
food. 

Vinegar  Versus  Lemon  Juice 

Vinegar  differs  from  lemon  juice  in  that  it  is  a  free 
acid,  being  a  solution  of  acetic  acid.  It  is  a  decom- 
position product  of  alcohol,  the  result  of  two  fermenta- 
tive processes,  and  because  of  its  irritating  properties, 
produces  disease;  while  lemon  juice  is  not  a  free  acid, 
but  an  acid  salt,  not  a  decomposition  product  but  is 
built  up  in  nature's  laboratory,  full  of  vitamines,  and 
a  cure  for  scurvy  and  many  cases  of  malnutrition. 

Some  one  has  well  said  that  "  mustard  produces  the 
same  effect  upon  the  inside  as  it  does  on  the  outside  of 
the  stomach." 


CONDIMENTS  143 

Says  Gautier :  "  Pepper  irritates  the  digestive  tract 
and  the  urinary  tract." 

An    Inflammatory    Thirst 

Condiments  create  an  inflammatory  thirst  which 
water  cannot  quench;  alcohol  is  able  to  quench  that 
thirst,  and  many  a  man  who  had  "  signed  the  pledge  " 
has  been  sent  back  to  the  saloon,  impelled  by  a  thirst 
stimulated  by  highly  seasoned  foods  served  to  him  by 
the  very  ones,  perhaps,  who  would,  if  they  but  knew 
how,  save  him  from  his  overwhelming  temptation. 

"  Many  mothers  who  deplore  the  intemperance  which 
they  see  everywhere  do  not  look  deep  enough  to  see 
the  cause.  They  are  daily  preparing  a  variety  of  dishes 
which  tempt  the  appetite  and  encourage  overeating. 
The  tables  of  our  American  people  are  generally  pre- 
pared in  a  way  to  produce  drunkards." — Ellen  G. 
White. 

Disease  or  Health 

And  a  still  greater  "  cloud  of  witnesses  "  might  be 
raised  up  against  these  much-used  articles.  But  enough 
has  been  presented  to  cause  the  thoughtful  mother  and 
housewife  to  hesitate  before  serving  to  her  family  foods 
so  seasoned  that,  even  though  the  immediate  effect  may 
seem  pleasing  and  satisfactory,  a  foundation  for  dis- 
ease rather  than  for  health  is  being  laid,  and,  in  some 
cases  at  least,  a  thirst  created  that  may  lead  to  a  more 
grievous  form  of  intemperance,  with  its  train  of  mis- 
ery and  woe. 

How  Much  Reserve? 

While  catarrh  of  the  stomach  and  bowels,  hardening 
of  the  liver,  and  Bright's  disease  are  not  in  every  case 
caused  by  the  use  of  condiments,  nevertheless  these 
things  are  factors  in  the  production  of  these  ever- 
increasing  diseases,  and  shorten  the  working  life  of 


144  THE    HOME   DIETITIAN 

these  organs.  Again  we  would  lay  emphasis  upon  the 
fact  that  the  reserve  strength  of  a  healthy  organ  cannot 
be  estimated.  Just  how  much  wear  and  tear  and  over- 
strain it  may  be  able  to  endure  we  can  never  know 
until  it  has  been  tried  out,  and  then  it  is  often  too  late; 
the  damage  is  already  done.  It  is  not  one  error  that 
brings  disease.  Nature  may  resist  and  override  the  few 
occasional  mistakes,  but  a  combination  of  factors,  a  con- 
tinued irritation  from  various  sources,  is  bound  even  in 
those  most  vigorous  to  bring  all  too  soon  the  time  of 
reckoning  and  the  day  when  the  strength  of  the  organs 
no  longer  enables  them  to  cope  with  the  adverse  con- 
ditions. And  their  ability  to  do  even  a  normal  amount 
of  work  is  often  so  greatly  impaired  that  the  individual 
must  walk,  with  a  crutch,  as  it  were,  permanently 
maimed,  his  vitality  lessened  and  his  life  shortened. 

An  important  part  of  the  treatment  of  the  diseases 
mentioned  in  this  connection  is  the  elimination  from  the 
diet  of  all  irritating  and  highly  seasoned  foods.  How 
much  better  to  avoid  those  things  which  tend  to  produce 
disease  and  to  let  our  regular  dietary  consist  of  the  foods 
so  bountifully  supplied  by  nature, —  the  natural  foods 
that  will  place  upon  our  bodies  no  handicap  in  the 
processes  of  assimilation  and  elimination. 

Keen   Enjoyment 

There  are  many  delicious  flavors  in  natural  foods;  the 
delightful  nectar  of  fruits,  the  rich  flavor  of  nuts,  the 
wholesomeness  of  grains,  the  savor  of  vegetables  and 
vegetable  broths, —  all  of  these  were  given  us  that  we 
might  derive  the  keenest  enjoyment  in  the  partaking  of 
them.  Careful  and  intelligent  preparation  will  bring 
out  delicacy  of  flavor  that  will  prove  delightful  and 
more  than  satisfactory  to  all  who  will  give  the  healthful 
way  an  unprejudiced  trial. 


CHAPTER  XVII 
UNNATURAL    STIMULANTS 

UNNATURAL  stimulants  are  any  substances  which  ex- 
cite cell  or  tissue  to  undue  activity  by  reason  of  their 
irritating  presence.  Condiments  would  be  included  un- 
der this  head,  but  as  they  have  already  been  discussed 
(see  previous  chapter),  we  shall  devote  the  contents  of 
this  chapter  to  those  stimulants  which  affect  the  nervous 
system.  These  are  substances  which  excite  the  brain 
and  nerves  to  abnormal  activity  by  reason  of  their  irri- 
tating presence  in  the  blood.  This  undue  stimulation 
is  always  followed  by  a  compensatory  period  of  depres- 
sion. This  is  more  than  a  mere  physiological  sedation, 
for  after  repeated  stimulation  of  this  sort  it  takes  more 
of  the  stimulant  to  produce  the  same  amount  of  activity, 
until  the  nerves  tend  toward  a  worn-out  state  or  a  con- 
dition of  exhaustion. 

Exhausted  nerves  are  always  irritable,  and  as  the  end 
result  of  a  continued  abnormal  stimulation  the  nerves 
become  weak,  unsteady,  and  unable  to  do  with  poise  and 
control  the  work  of  governing  the  muscular  mechanism 
of  the  body.  Under  the  head  of  such  stimulants  may 
be  classed:  Alcohol,  tobacco,  various  drugs,  many  patent 
medicines,  tea,  coffee,  cocoa,  and  meat  juices. 

Alcohol,  the  great  destroyer  of  the  race,  we  need  not 
discuss  here.  Tobacco,  a  menace  to  the  physical,  and 
intellectual  integrity  of  mankind,  is  not  included  in  the 
realm  of  dietetics.  The  promiscuous  use  of  drugs  and 
patent  medicines  the  people  are  being,  to  an  extent, 
saved  from  by  educational  campaigns  and  the  law. 
But  coming  more  strictly  in  the  province  of  our  dis- 

10  145 


146  THE    HOME   DIETITIAN 

cussion,  and  often  apparently  innocent  in  their  effects, 
are  those  in  the  remainder  of  the  list  —  tea,  coffee, 
cocoa,  and  meat  juices. 

Tea:  "  That  social  cup  which  sharpens  wit,  brightens 
repartee,  accelerates  the  flow  of  ideas,  quickens  the 
pulse,  relieves  one  of  headache  and  fatigue,  and  drives 
away  dull  care,  is  not  the  innocent  benefactor  of  the  race 
that  it  may  seem  to  be.  Instead,  it  is  a  deceiver  which, 
commending  itself  for  the  present  as  a  thing  '  to  be  de- 
sired to  make  one  wise  '  and  well,  in  the  end  robs  one 
of  a  hundredfold  more  of  the  very  things  it  seems  to 
give."  —  D.  D.  Comstock,  M.  D.,  in  Signs  of  the  Times, 
July,  1917. 

Theine 

Tea  contains  two  injurious  extractives  —  a  somewhat 
bitter  alkaloidal  poison  called  theine,  and  an  astringent 
acid  called  tannin.  A  small  cup  of  tea  —  four  ounces 
—  will  contain  from  one-half  to  one  grain  of  theine  and 
a  variable  amount  of  tannic  acid.  The  physiological 
effects  of  theine  are  principally  those  of  stimulation. 
It  is  an  excitant  to  the  brain,  quickens  the  pulse,  and 
raises  blood  pressure,  apparently  relieving  fatigue. 

"  Used  in  excess,  it  [tea]  exerts  a  harmful  influence 
upon  the  nervous  system,  and  in  too  strong  a  form  in- 
jures the  digestive  tract  and  function."  —  Harrington 
and  Richardson's  "Practical  Hygiene,"  edition  1911, 
p.  212. 

According  to  Bullard,  "  the  abuse  of  tea  as  a  beverage 
leads  to  ringing  in  the  ears,  tremor,  nervousness,  head- 
ache, neuralgia,  and  constipation." 

A  Habit- Forming  Drug 

Practically  all  medical  authorities  classify  theine  with 
the  habit-forming  drugs,  such  as  morphine,  cocaine,  and 
alcohol.  Who  shall  say,  then,  just  what  is  excess  or 


UNNATURAL   STIMULANTS  147 

abuse?  Experiments  of  the  Pasteur  Institute  have 
shown  that  the  long-continued  use  of  even  very  small 
doses  of  poison  ultimately  produces  decided  injury  to 
the  organism,  and  some  observers  say  that  a  given 
amount  of  poison  taken  in  small  doses  over  a  long  period 
of  time  does  more  harm  than  if  taken  in  large  doses  at 
infrequent  intervals, —  just  as  there  is  greater  damage 
inflicted  by  alcohol  on  the  "  tippler  "  than  on  the  man 
who  goes  on  a  "  spree "  occasionally,  but  abstains  at 
other  times. 

The  astringent  action  of  the  tannic  acid  of  tea  in  its 
effect  on  the  bowel  is  no  small  factor  in  the  causation 
of  the  prevalent  disease,  constipation,  and  many  a  girl 
and  young  woman  has  laid  the  foundation  for  future  ill 
health  in  her  daily  indulgence  in  a  cup  of  tea. 

A  Tragedy 

"  With  nerves  all  a-quiver  with  theine,  and  the  bowels 
all  puckered  with  tannin,  what  an  amazing  preparation 
for  the  battles  of  life !  It  is  but  little  short  of  a  tragedy 
that  a  girl  of  a  nervous  and  artistic  temperament,  with 
a  natural  tendency  toward  functional  disease  of  the 
nervous  system,  should  be  encouraged  or  even  allowed 
by  her  parents  to  begin  so  young  to  cultivate  a  disorder 
toward  which  she  has  a  natural  bent, —  nervous  pros- 
tration and  chronic  constipation, —  through  the  free  use 
of  tea  and  other  nerve  stimulants  and  sedatives."  — 
D.  D.  Comstock,  M.  D. 

Caffeine 

Coffee:  The  stimulating  principle  of  coffee  is  caffeine, 
which  is  practically  the  same  as  the  theine  of  tea,  and 
identical  in  its  effects,  and  much  that  has  been  said  of 
tea  might  also  be  said  of  coffee.  Caffeine  is  a  drug  that 
is  commonly  used  in  headache  powders  or  is  prescribed 
by  physicians  when  an  emergency  stimulant  is  needed. 


148  THE    HOME   DIETITIAN 

Coffee  contains  about  2  grains  of  caffeine  to  the  cup. 
and  thus  its  effect  upon  the  nervous  system  is  even 
more  marked  than  that  of  tea;  and  while  tea,  because 
of  its  astringent  action,  interferes  with  the  normal 
peristalsis  of  the  intestine,  coffee  interferes  to  a  greater 
extent  with  stomach  digestion. 

15,000,000  Pounds 

American  people  yearly  consume  about  15,000,000 
pounds  of  caffeine,  which  if  given  at  one  time  would 
kill  the  whole  world  at  one  dose.  This,  if  divided  into 
doses,  would  equal  more  than  100,000,000,000  doses  an- 
nually, or  a  little  more  than  3  grains  daily  for  every 
man,  woman,  and  child  in  the  nation.  Surely  this  can- 
not tend  toward  the  physical  uplift  of  the  race,  but 
must  have  its  effect  in  the  gradual  increase  of  chronic 
disease. 

Quoting  from  Gautier :  "  Coffee,  as  everybody  knows, 
produces  a  nervous  excitement,  which  if  abused  may 
lead  to  insomnia,  hallucinations,  troubles  of  the  circu- 
lation, and  muscular  enervation,  to  pericardial  distress 
and  to  dyspnea.  One  can  become  caffeic,  just  as  one 
can  become  alcoholic  or  a  morphia  maniac." 

And  again  from  Harrington  and  Richardson's  "  Prac- 
tical Hygiene,"  edition  1911,  page  214:  "Taken  in  ex- 
cessive quantities,  it  [coffee]  causes  palpitation  and  in- 
termittence,  besides  general  nervousness  and  derange- 
ment of  digestion.  It  has  a  marked  inhibitory  influence 
on  gastric  digestion,  and  is  more  oppressive  to  the 
stomach  than  tea,  and,  hence,  should  be  used  with  cau- 
tion by  dyspeptics." 

For  That  Headache 

The  headache  that  one  has  when  deprived  of  his 
morning  coffee  or  his  daily  portion  of  tea,  is  one  of  the 
greatest  evidences  that  the  nervous  system  has  learned 


UNNATURAL   STIMULANTS  149 

to  depend  upon  the  artificial  stimulation,  and  that,  sooner 
or  later,  if  the  habit  is  continued,  nature  will  reach  the 
place 'where  she  can  no  longer  cope  with  the  situation, 
and  the  collapse  will  come. 

"  There  can  be  no  doubt  that  the  human  race  would 
be  better  off  if  these  beverages  had  never  been  dis- 
covered; and  many  cases  of  nervousness,  dyspepsia,  and 
constipation  would  be  either  greatly  helped  or  entirely 
relieved  if  these  beverages  were  banished  from  our 
tables."  -"The  Science  of  Living,"  Sadler,  p.  162. 

Theobromine 

Cocoa:  Many  giving  up  tea  and  coffee  feel  that  they 
can  indulge  themselves  freely  in  cocoa,  but  here  again 
a  mistake  is  made;  for  even  in  the  use  of  this  delightful 
beverage,  care  and  moderation  should  be  exercised.  It 
contains  the  active  principle  theobromine,  which  is  re- 
lated to  caffeine,  though  not  so  deleterious  in  its  effects, 
it  not  having  the  untoward  effect  on  the  cerebral  centers 
and  the  heart  that  does  the  active  principle  of  either 
coffee  or  tea.  However,  it  is  a  drug,  its  drug  action 
affecting  principally  the  kidneys  and  urinary  tract.  A 
cup  of  cocoa  contains  about  one  half  as  much  of  its 
active  principle  as  does  tea  or  coffee,  and  the  theobro- 
mine may  be  considered  one  half  as  injurious  in  its 
effects  as  caffeine. 

Cocoa  has  an  advantage  over  tea  and  coffee.  Being 
rich  in  fat  and  protein,  it  has  rather  a  high  food  value. 
Chocolate  and  cocoa  are  the  same,  except  that  in  cocoa 
the  fat  has  been  largely  removed.  This  fat  is  placed 
on  the  market  as  cocoa  butter. 

So  while  not  so  much  can  be  said  against  cocoa  as 
can  be  said  against  tea  and  coffee,  and  it  may  at 
times  serve  a  useful  purpose  as  food,  yet  it  should  be 
used  only  with  care  and  moderation.  Especially  should 


150  THE    HOME   DIETITIAN 

children  be  kept  from  the  use  of  cocoa,  it  being  particu- 
larly deleterious  to  them  because  of  its  action  on  the 
urinary  tract. 

Little   Foxes 

Truly  it  is  "  the  little  foxes  that  spoil  the  vines,"  and 
our  safety  and  greatest  efficiency  lie  in  a  selection  of 
food  which  will  yield  the  highest  results  healthwise, 
and  in  the  avoiding  of  those  things  which  are  question- 
able in  their  effects. 

Meat  Extractives:  The  end  products  of  protein  me- 
tabolism already  described  are  closely  related  to  caffeine ; 
hence  the  stimulating  effect  of  meat  and  meat  broths, 
which,  when  taken,  add  these  extractives  in  excess  to 
those  already  formed  normally  in  the  tissues,  and  the 
sensation  of  weakness  when  they  are  omitted  from  the 
dietary  by  one  accustomed  to  having  them. 

A   Devitalizing   Effect 

The  feeling  of  strength  obtained  from  meat  broths  is 
thus  not  a  true  tonic,  but  an  unnatural  stimulant,  which 
if  freely  indulged  in  cannot  but  have  in  the  end  a  de- 
vitalizing effect  upon  the  general  nervous  system. 

Eating  for  health  means  eliminating  from  one's  diet 
those  things  which  tend  to  make  for  disease  and  race 
decadence,  and  subsisting  on  those  foods  so  abundant 
that  are  full  of  life  and  health  properties.  The  more 
we  are  able  to  reach  this  ideal  the  nearer  does  the  body 
approach  the  normal  state,  which  means  not  only  ful- 
ness of  physical  but  of  intellectual  strength. 

"  Blessed  art  thou,  0  land,  when  .  .  .  thy 
princes  eat  in  due  season,  for  strength,  and  not 
for  drunkenness," —  Bible. 


CHAPTER  XVIII 
DESSERTS 

Insult  Added  to  Injury 

THIS  most  pleasing  part  of  our  meal  comes  to  us, 
usually,  when  hunger  is  satisfied  and  the  needs  of  the 
body  have  been  supplied  by  that  part  which  has  gone 
before.  Thus  the  digestive  powers  are  overtaxed,  tv 
body  is  burdened  by  an  excess  of  food,  and  actual  harm 
is  often  done,  though  the  dish  might  of  itself  be  whole- 
some. However,  desserts  are  frequently  not  wholesome, 
and  then  the  food  which  is  imposed  upon  an  already 
more  than  satisfied  stomach  is  of  such  a  quality  that  in- 
sult is  added  to  injury. 

The  so-called  best  chef  is  the  one  who  can  make  a 
dessert  so  tempting  that  it  will  appeal  to  the  palate  of 
one  who  is  already  surfeited  with  food,  and  again  we 
are  reminded  of  the  frequency  with  which  the  question 
of  supplying  physiological  need  is  lost  sight  of  in  the 
desire  to  cater  to  the  sense  appeal.  When  one  is  truly 
hungry,  it  is  not  the  dessert  that  satisfies,  but  the  home- 
lier part  of  the  meal,  and  the  tendency  is  to  wait  until 
the  appetite  wanes  before  partaking  of  that  which  is 
often  of  the  most  concentrated  food  value. 

The  best  desserts  are  light,  easily  digested,  and  of  a 
minimum  caloric  value.  They  must  not  be  of  such  con- 
centration that  they  interfere  with  the  proper  food  bal- 
ance. If  the  first  part  of  the  meal  is  low  in  calories  and 
it  is  planned  that  the  dessert  supply  a  large  part  of  the 
food  value,  making  with  the  remainder  of  the  food 
served  a  proper  balance,  a  more  concentrated  dessert 
may  be  served,  e.  g.,  the  following: 

151 


152  THE   HOME   DIETITIAN 

Protein  Calories         Total  Calories 

Cottage  cheese,  2  ounces   40  75 

Spinach,  2  heaping  tablespoons  ...     8  25 

Apple  pie,  one  sixth  of  a  pie 16  350 

Walnuts  (6)    20  200 

Glass  of  milk  .   28  150 


112  800 

Per  cent  of  protein  for  the  meal,  14. 

The  Proper  Food  Balance  Maintained 

Note  the  ample  total  food  units,  and  the  protein  - 
half  the  daily  needs,  in  spite  of  the  fact  that  the  pie 
contains  only  41/2  per  cent  protein.  The  low  protein  of 
the  pie  is  made  up  by  the  high  protein  content  of  the 
other  food.  While  pie  may  not  be  considered  the  most 
wholesome  of  desserts  and  would  better  be  served  only 
occasionally,  yet  much  of  its  unhealthfulness  is  avoided 
when  it  is  given  its  rightful  place  in  the  meal.  The 
pie  and  nuts,  making  a  dessert  of  550  calories,  would 
undoubtedly  be  a  great  imposition  upon  a  digestive  tract 
after  the  ordinary  dinner  of  three  or  four  courses.  This 
would  in  reality  be  serving  a  second  full  meal  when  the 
digestive  organs  already  have  all  they  can  do. 

Usually  the  dessert  of  150  food  units  or  less  is  the 
best,  and  many  very  delightful  dishes  of  this  kind  can 
be  prepared.  (See  recipes,  Chapter  XXXI.) 

A  Disadvantage 

One  great  disadvantage  in  desserts  is  the  large 
amount  of  fat  and  sugar  of  which  they  are  usually 
made.  If  care  is  not  taken,  this  will  result  in  a  meal 
overbalanced  as  regards  its  carbohydrate  and  fat  con- 
tent, at  the  same  time  irritating  because  of  its  con- 
centrated sweet  and  overheated  fat,  and  more  or  less 


DESSERTS  153 

indigestible,  especially  if  added  to  an  already  overloaded 
stomach. 

How  to   Combine 

Desserts  should  be  made  of  food  substances  in  proper 
combination.  For  instance,  combinations  of  milk  and 
sugar  are  not  the  most  wholesome,  and  greatly  increase 
a  tendency  to  gastric  fermentation.  (See  recipes,  Chap- 
ter XXXI,  for  desserts  without  the  milk  and  sugar  com- 
bination.) The  combination  of  fruits  and  vegetables  is 
not  considered  ideal,  and  if  a  fruit  dessert  is  served  after 
a  hearty  vegetable  meal,  it  should  preferably  be  one  in 
which  the  cellulose  of  the  fruit  has  been  largely  re- 
moved. 

Candy 

The  time  for  candy  is  at  the  end  of  the  meal,  at  which 
time  it  may  be  served  with  the  dessert.  When  it  takes 
its  place  as  a  part  of  the  meal,  its  food  value  being 
reckoned  with  the  daily  ration,  one  great  objection  to 
its  use  is  removed.  The  appetite  already  satisfied,  the 
tendency  to  overeat  of  it  is  greatly  lessened,  and  it  does 
not  prove  so  irritating  to  the  mucous  membrane  when 
not  taken  on  an  empty  stomach.  However,  candy  eaten 
in  excess  even  at  this  time  often  results  in  marked  irri- 
tation of  the  throat  and  increased  catarrhal  conditions. 

Nuts 

Nuts  are  sometimes  served  with  the  dessert,  and  much 
blame  is  often  attached  to  this  most  valuable  article  of 
food  because  it  so  often  plays  a  part  in  the  overeating 
frequently  indulged  in  during  this  last  most  delightful 
course.  The  high  caloric  value  of  nuts  must  be  kept  in 
mind  and  they  should  be  eaten  accordingly.  Nuts  served 
with  a  simple  fruit  dessert  make  a  most  satisfactory 
combination  in  which  the  food  concentration  need  not 
be  too  great.  Nuts  often  cause  distress  because  they 


154  THE    HOME   DIETITIAN 

are  improperly  masticated.  If  thoroughly  chewed  and 
eaten  moderately,  as  all  concentrated  foods  should  be; 
if  eaten  at  the  proper  time  and  place  and  considered  a 
food  with  actual  food  value  instead  of  something  merely 
to  please  the  palate,  this  pleasing  as  well  as  nourishing 
food  may  be  eaten  by  nearly  every  one  with  no  unsatis- 
factory results. 

Ice  Cream 

Ice  cream,  so  often  served,  should  be  mentioned,  and 
the  same  rules  apply  to  this  as  to  all  others.  It  must  be 
eaten  with  due  regard  for  what  has  preceded  it.  Be- 
cause of  its  combination  and  concentration,  it  cannot 
be  considered  as  wholly  without  objection,  but  if  eaten 
in  moderation  and  slowly  so  that  large  ice-cold  masses 
are  not  thrown  upon  the  stomach  at  once,  thus  too 
quickly  lowering  the  temperature  below  that  at  which 
digestion  can  be  carried  on,  it  need  not  be  condemned. 
As  a  dessert  it  is  much  to  be  preferred  to  the  rich 
puddings  and  pastries  so  often  served.  A  good  time  for 
ice  cream  is  at  lunch  when  little  else  is  taken.  A  plain 
cracker  eaten  with  ice  cream  makes  a  more  rational 
combination  than  the  conventional  cake.  Sometimes  an 
invalid  can  take  ice  cream  better  than  anything  else. 
At  these  times  it  is  usually  served  by  itself  and  sup- 
plies needed  nourishment.  Melted  before  it  reaches  the 
stomach,  it  is  little  more  than  a  liquid  and  is  usually 
well  taken  care  of. 

Cakes 

Rich  cakes  and  pastries  are  better  omitted.  Simple 
cakes,  made  preferably  without  baking  powder  (see 
recipe  102),  may  be  served  occasionally,  but  as  a  usual 
thing,  the  fewer  of  these  sweets  supplied  the  family 
table  the  better.  And  when  for  economy's  sake,  or  lack 
of  time,  the  dessert  is  forgotten  or  omitted,  none  need 
feel  that  the  body  will  suffer  because  of  the  omission. 


CHAPTER  XIX 
MEAT  SUBSTITUTES  AND  SUGGESTIVE  MENUS 

UPON  meat  and  the  savors  derived  from  it,  depend- 
ence has  always  been  placed  to  make  food  palatable 
and  appetizing. 

With  meats  taken  from  us,  free  fats  in  disfavor, 
condiments  disallowed,  what  can  we  do  in  the  way  of 
preparing  dishes  that  will  not  only  supply  the  body 
needs,  but  will  also  meet  the  demands  of  often  wrongly 
educated  palates?  Surely  we  should  feel  quite  helpless 
and  find  the  problem  very  difficult  to  solve.  However, 
a  practical  study  may  enable  us  to  "  find  a  way." 

Threefold 

In  preparing  meat  substitutes  we  must  think  of,  (1) 
broths,  (2)  meat  dishes,  and  (3)  gravies.  These  foods 
must  be  appetizing.  The  broths  should  have  something 
of  the  same  savory  appeal  to  the  palate  as  have  the 
meat  juices;  the  meat  dishes  must  supply  the  neces- 
sary amount  of  tissue-building  element;  and  the  gravies, 
while  palatable,  must  be  free  from  excess  of  grease, 
especially  superheated  fats. 

A   Natural  Tonic 

1.  Broths  and  Soups. —  Vegetables,  properly  prepared, 
yield  the  most  delicious  and  appetizing  flavors.  In  fact, 
vegetable  bouillon  may  be  so  like  the  ordinary  meat 
broth  in  its  savor  that  many  can  scarcely  be  per- 
suaded of  the  absence  of  all  meat  extract  in  its  prepa- 
ration. Moreover,  such  vegetable  broths  are  rich  in 
the  mineral  salts  and  vitamines  so  essential.  For  the 
invalid  they  will  have  all  the  advantages  of  an  appe- 

155 


156  THE    HOME   DIETITIAN 

tizer  and   tonic   without   the   contamination    of   animal 
wastes  and  purine  stimulation. 

The  vegetables,  having  been  cut  up  without  paring, 
should  be  put  to  cook  in  cold,  unsalted  water  and  al- 
lowed to  simmer  two  or  three  hours.  In  this  way  the 
mineral  matter,  vitamines,  and  much  of  the  protein 
pass  into  the  broth,  the  temperature  probably  not 
greatly  affecting  the  vitamines.  (See  page  107.)  In 
boiling  vigorously  for  that  length  of  time  a  greater 
risk  is  run  of  destroying  the  vital  elements. 

Soup  Stock 

The  most  important  part  of  the  nourishment  being 
near  the  skin,  a  most  nutritious  vegetable  broth  can  be 
made  by  using  simply  the  parings  of  potatoes  and  other 
vegetables.  (See  recipe  24.)  These,  having  been  thor- 
oughly cleansed,  may  be  used  to  excellent  advantage  in 
the  preparation  of  broths  and  soup  stock.  No  fat 
should  be  added,  but  after  straining  or  pressing  through 
a  colander,  seasoning  in  the  way  of  salt,  celery  salt,  a 
bay  leaf,  or  a  pinch  of  thyme,  may  be  added.  Any 
combination  of  vegetables  may  be  used  with  good  re- 
sults, and  the  water  from  any  vegetable  may  be  added 
to  these,  to  make  a  delicious  vegetable  broth,  or  it  may 
be  used  by  itself.  For  example,  instead  of  throwing 
away  cauliflower  water,  add  it  to  the  soup  or  broth 
already  made,  or  serve  it  by  itself,  hot  and  salted  to 
taste,  in  bouillon  cups.  It  will  make  a  pleasing  addi- 
tion to  the  meal. 

Tea  or  Leaves,  Which? 

Likewise  may  be  used  the  water  from  string  beans, 
asparagus,  and  from  even  cabbage  or  beets.  Some  of 
these  may  need  to  be  combined  in  various  ways  to  in- 
sure a  good  flavor,  but  always  should  be  used.  What 
tea  lover  would  eat  the  tea  leaves  and  throw  the  tea 


MEAT    SUBSTITUTES  157 

down  the  sink?  Potato  water,  bean  broth,  alone  or 
together,  seasoned  by  cooking  with  them  a  bit  of  celery, 
onion,  and  tomato,  give  a  flavor  which  may  rival  that 
of  a  consomme.  The  ingenuity  of  the  housewife  makes 
possible  any  number  of  the  most  savory  and  delightful 
combinations. 

Vegex,  also  herbex,  is  a  factory-prepared  vegetable 
extract  which  makes,  when  added  to  boiling  water,  a 
very  good  bouillon  comparable  to  that  prepared  from 
bouillon  cubes.  (See  recipe  39.) 

A  very  meaty  flavor  may  be  given  vegetable  soups 
and  purees  by  using  as  a  basis  a  stock  prepared  as  in 
recipe  25. 

An  Essential 

2.  Substitute  Meat  Dishes. —  The  essential  for  these 
dishes  as  meat  substitutes  is,  first,  that  they  contain  a 
relatively  high  proportion  of  protein.  In  this  way  only 
can  they  replace  flesh  food,  which  usually  contains  30 
per  cent  or  more  of  the  nitrogenous  element.  Often 
dishes  are  served  as  meat  substitutes  which  contain  a 
very  small  percentage  of  protein,  and  are,  in  reality, 
starchy  rather  than  nitrogenous  foods.  Something 
more  than  the  taste  must  be  considered  if  we  are 
rightly  to  supply  the  body  demand.  However,  the  fla- 
vor cannot  be  ignored,  and  the  dish,  to  be  a  success, 
must  satisfy  the  palate  as  well.  For  foods  that,  be- 
cause of  their  large  protein  content,  are  good  meat 
substitutes,  see  table,  Chapter  VI. 

For  Breakfast 

For  at  least  two  of  the  daily  meals,  a  protein  dish 
should  be  planned.  For  breakfast  it  may  be  an  egg, 
cottage  cheese,  cottage  cheese  omelet,  milk  toast,  gluten 
mush  or  gruel,  or  any  of  the  whole  grains,  as  oatmeal, 
whole  or  cracked  wheat,  whole  rice,  pearled  barley. 


158  THE    HOME   DIETITIAN 

These  grains  contain  in  themselves  15  per  cent  or  more 
protein.  When  eaten  with  milk,  the  protein  may  reach 
18  per  cent.  The  addition  of  sugar  is  a  mistake  for 
two  reasons:  First,  because  sugar  and  milk  are  not  a 
good  combination  (see  Chapter  XX)  ;  and  second,  be- 
cause the  extra  food  units  of  sugar  greatly  disturb  the 
protein  balance.  Cream  may  be  used  if  other  fats  in 
the  meal  are  limited,  but  as  a  protein  dish  the  cereal 
has  its  greatest  advantage  when  eaten  with  whole  milk. 

No  better  change  can  be  made  in  the  breakfast  plan 
than  a  cup  of  hot  milk  in  place  of  the  time-honored 
cup  of  coffee.  The  proverbial  breakfast  mush  may  be 
changed  from  time  to  time  to  a  gruel  (see  recipes  19 
and  20),  to  shredded  wheat,  or  to  corn  flakes.  Baked 
potato,  with  an  accompanying  egg,  may  well  be  served 
at  breakfast  time,  with  perhaps  a  glass  of  milk.  The 
potato  in  this  case  should  take  the  place  of  breakfast 
cereal  unless  in  the  form  of  zwieback  or  breakfast 
gems.  Puree  of  peas  on  toast,  asparagus  tips,  or  other 
easily  digested  vegetable  is  often  good  if  one  does  not 
have  dinner  until  late  in  the  day. 

Fresh  fruit  should  form  a  part  of  every  breakfast, 
and,  as  mentioned  elsewhere,  should  be  eaten  first.  In 
this  way  the  full  benefit  of  the  fruit  is  obtained  by  the 
system,  and  there  is  less  danger  of  trouble  due  to  the 
combination.  Stewed  fruits  may  be  used,  as  desired, 
and  may  be  taken  during  or  at  the  end  of  the  meal. 
But  they  should  never  be  allowed,  unless  of  necessity, 
to  take  the  place  of  fresh  fruit.  A  fruit  salad  for 
breakfast  makes  a  pleasant  variation.  (See  recipe  74.) 
Nuts  are  a  good  addition  to  the  breakfast  menu,  but 
supply  fat  rather  than  a  great  deal  of  protein.  The 
peanut  and  almond  are  higher  in  protein  than  other  nuts. 

As  five,  or  better  six,  hours  should  elapse  between 
meals,  the  two-meal-a-day  plan  would  prove  a  benefit  to 


MEAT    SUBSTITUTES  159 

many,  with,  perhaps,  a  third  fruit  meal.  The  ideal 
plan,  were  it  possible,  would  be  a  breakfast  at  nine 
and  dinner  at  three  or  four.  This  is  so  rarely  possible 
that  one  of  two  or  three  other  plans  must  be  substi- 
tuted. Many  find  the  no-breakfast  plan  a  good  one  (or 
a  breakfast  of  fruit),  with  an  early  lunch  and  an  eve- 
ning dinner.  Others  will  do  well  with  a  substantial 
breakfast,  a  fruit  lunch,  and  a  heavier  meal  later  in 
the  day.  Often  the  best  that  can  be  done  is  breakfast 
between  seven  and  eight,  lunch  between  twelve  and 
one,  and  dinner  about  six. 

For  Lunch 

In  this  case  the  lunch  should  be  light,  only  of  fruit 
or  other  easily  digested  food,  as  perhaps  soup,  with 
zwieback  or  a  sandwich.  The  dinner  should  then  be 
eaten  as  soon  after  five  as  possible.  If  it  is  possible  to 
serve  dinner  in  the  middle  of  the  day,  preferably  about 
one,  then  the  evening  meal  should  be  light  and  easy 
to  digest.  A  fruit  meal  in  the  evening  is  very  good,  with 
perhaps  zwieback,  dextrinized  cereal,  or  vegetable  soup. 

If  one's  protein  for  the  other  meals  of  the  day  has 
been  low,  he  may  well  have  a  hot  milk  toast,  a  cream 
vegetable  soup,  an  egg,  or  a  glass  of  milk  or  of  butter- 
milk. However,  a  simple  fruit  supper  is  the  one  that 
will  insure  the  best  night's  rest  and  the  sweetest  taste 
in  the  morning.  Few,  except  those  who  are  working 
vigorously  with  their  muscles,  can  properly  digest  three 
hearty  meals  a  day. 

Many  in  trying  to  do  this,  especially  those  in  seden- 
tary work,  find  their  systems  becoming  clogged,  with 
headache,  loss  of  appetite,  and  other  symptoms  of  stag- 
nant conditions  in  the  digestive  tract  and  tissues.  Un- 
fortunately, these  people  often  do  not  recognize  the 
cause  of  the  trouble. 


160  THE    HOME   DIETITIAN 

For  Dinner 

The  dinner,  whether  served  at  midday  or  evening, 
should  be  very  carefully  planned.  It  is  well  to  decide 
first  upon  the  form  in  which  the  protein  is  to  be  sup- 
plied, then  to  select  the  other  foods  accordingly.  If 
legumes,  such  as  peas,  beans,  or  lentils,  are  to  be  served, 
or  cottage  cheese,  either  as  a  salad  or  a  meat  dish,  it 
may  not  be  necessary  to  plan  a  special  meat  substitute. 
However,  it  is  often  very  pleasing  to  serve  a  dish  which 
will  seem  more  nearly  to  take  the  place  of  meat,  such 
as  in  'recipes  41  to  58.  These  may  be  served  with 
sauces  or  gravies  which  will  add  greatly  to  the  meaty 
flavor. 

A  soup,  a  raw  vegetable  salad,  one  or  both,  may  well 
form  a  part  of  every  dinner.  If  these  are  served  with 
a  good  protein  dish,  one  cooked  vegetable  may  be  quite 
sufficient,  although  a  second  may  be  added  if  desired. 
If  there  is  no  specially  prepared  salad,  something  raw 
should  be  served,  if  only  celery  or  lettuce. 

Potatoes  need  not  always  be  included.  It  may  be 
well  on  alternate  days  to  serve  one  or  two  other  vege- 
tables and  omit  the  potato.  Potato,  while  a  valuable 
food,  should  never  be  allowed  to  take  the  place  of  green 
or  leafy  vegetables.  If  squash  or  carrots  are  served, 
the  second  vegetable  would  better  be  spinach,  string 
beans,  green  peas,  etc.,  rather  than  potato.  Many  are 
content  to  limit  the  vegetable  par,t  of  their  daily  ration 
to  potato,  with  only  exceptional  variation.  This  is  a 
mistake. 

Dessert  is  by  no  means  always  necessary,  but  if 
served,  should  be  simple.  If  the  dessert  is  heavy  and 
concentrated  as,  e.  g.,  pie,  the  rest  of  the  meal  should 
be  light.  (See  Chapter  XVIII.) 

The  planning  of  the  dinner  should  depend  to  a  large 
extent  upon  whether  those  who  eat  of  it  are  farmers, 


MEAT    SUBSTITUTES  161 

carpenters,  and  draymen,  or  clerks,  stenographers,  and 
professional  people.  Those  who  work  hard  at  muscular 
labor  can  digest  food  in  kind  and  amount  that  the 
brain  worker  could  never  take  care  of.  The  needs  of 
the  two,  especially  as  to  the  amount  of  energy  food 
required,  are  very  different. 

In  planning  every  dinner,  especially  for  those  of  the 
sedentary  class,  it  will  be  well  to  remember  that  the 
protein  portion  should  average  13  to  15  per  cent,  or 
more  of  the  total  number  of  calories,  unless  the  break- 
fast has  been  high  in  protein.  This  will  make  up  for 
those  meals  in  which  fruit  and  other  foods  low  in  pro- 
tein constitute  a  large  part. 

As  has  been  said  before,  both  classes  need  about  the 
same  amount  of  protein,  but  the  total  calories  needed 
by  the  first  class  may  in  some  cases  be  twice  as  much 
as  needed  by  the  second.  The  appetite  of  the  first  is 
often  a  safe  guide,  but  not  so  with  the  second. 

3.  Gravies. —  We  cannot  leave  the  question  of  meat 
substitutes  without  discussing  the  question  of  gravies, 
those  questionable  meat  accessories  so  often  used  to 
cover  up  dishes  of  uncertain  source  and  many  times 
depended  upon  to  insure  an  appetizing  flavor. 

Unhygienic  Gravies 

Many  would  be  quite  willing  to  eliminate  flesh  food 
from  their  diet  were  it  possible  still  to  have  the  rich 
savory  gravies  usually  served  with  meat.  Vegetarians, 
in  their  effort  to  supply  something  that  will  take  the 
place  of  these  sauces,  often  serve  gravies  which  are  any- 
thing but  hygienic  because  of  their  excess  of  grease 
and  superheated  fat.  These  have  little  advantage  over 
meat  gravies  in  their  effect  upon  the  health,  and  may 
even  make  a  meal  more  unhealthful  than  one  in  which 
meat  is  served. 
11 


162  THE   HOME   DIETITIAN 

However,  it  is  very  possible  to  make  these  desired 
sauces  from  vegetable  broths  and  extracts,  and  have 
them  full  of  important  nutritional  elements,  health- 
giving  as  well  as  appetizing.  A  very  enjoyable  and 
healthful  dressing  for  vegetables  and  entrees  may  be 
prepared  by  using  a  vegetable  broth  as  a  basis.  Potato 
water,  thickened  with  flour,  and  milk  or  cream  added, 
makes  a  very  delicious  milk  gravy.  In  the  same  way 
the  water  from  boiled  onions,  string  beans,  and  other 
vegetables  may  be  thickened  to  make  cream  sauces  of 
various  kinds. 

In  making  potato  and  onion  soup  stock  according  to 
recipe  25,  before  putting  through  a  colander,  pour  or 
strain  off  a  pint  or  more  of  the  rich  brown  liquor.  Add 
a  little  strained  tomato  to  this,  just  enough  to  give  it  a 
little  flavor,  not  enough  to  give  a  tomato  color,  unless 
a  tomato  sauce  is  desired.  Brown  flour  in  the  oven  or 
over  the  flame  in  a  dry  pan,  without  oil,  and  use  this 
flour  for  thickening.  Salt  to  taste  and,  if  desired,  sea- 
son with  celery  salt,  thyme,  or  sage.  The  result  will 
be  a  brown  gravy  surprisingly  satisfactory  as  to  flavor, 
and  wholesome  withal.  No  fat  need  be  added  to  this 
gravy.  Milk  or  cream  may  be  added;  but  if  so,  it  will 
be  well  to  omit  the  tomato.  By  adding  more  tomato  a 
delicious  tomato  sauce  may  be  made.  For  other  reci- 
pes, see  Chapter  XXXI. 

There  are  many  ways  in  which  the  ingenious  house- 
wife can  apply  the  above  suggestions,  but  for  those 
who  may  wish  a  little  more  assistance  in  the  practical 
working  out  of  these  daily  problems,  we  append  a  few 
suggestive  menus,  which,  after  the  housewife  has  gotten 
well  on  in  the  way  of  preparing  well-balanced  and 
wholesome  meals  for  her  family,  she  may  in  many 
ways  vary  and  improve. 


MEAT   SUBSTITUTES 


163 


Sample  Breakfast  Menus 


Protein  Total 

No.    1                                                                                                       Calories  Calories 

Fruit  Salad  (see  pages  211,  212)    13  181 

Oatmeal     14  75 

Milk    (8   oz.)    32  160 

Zwieback     14  100 

Dates   (4)    3  100 

Per  cent  of  protein  for  the  meal,  12. 

76  616 

Protein  Total 

No.   2                                                                                                       Calories  Calories 

Orange  Juice   ( 7  oz. )    7  100 

Whole-wheat  Gems   (2)    30  192 

Butter    50 

Soft   Egg     25  75 

Prunes    (4)     3  100 

Almonds    (6)     15  100 

Per  cent  of  protein  for  the  meal,  13. 

,                                                                                                80  617 

Protein  Total 

No.    3                                                                                                       Calories  Calories 

Fruit  Salad    13  181 

Cracked  Wheat  and  Milk   25  164 

Whole-wheat  Gems    30  192 

Butter   (thin  pat)    50 

Cereal  Coffee   (teaspoon  sugar,  1  oz.  evap.  milk)  . .     8  65 

Almonds  (4  or  more)   8  60 

Per  cent  of  protein  for  the  meal,  12.  — 

84  712 

L.,  . 

Protein  Total 

No.    4                                                                                                       Calories  Calories 

Cantaloupe      5  75 

Omelet     27  90 

Baked    Potato    10  100 

Corn   Bread    18  150 

Butter    (2  thin  pats)    100 

Hot  Milk    (6  oz.)    27  140 

Per  cent  of  protein  for  the  meal,  13. 
£*„ 

Protein  Total 

No.   5                                                                                                      Calories  Calories 

Grapefruit  (1)   with  teaspoon  honey   7  125 

Whole  or  Brown  Rice 25  161 

Fruit  Toast   .             15  158 


164  THE   HOME   DIETITIAN 

Protose  Loaf 45  100 

Whole-wheat  Sticks    (3)    10  100 

Per  cent  of  protein  for  the  meal,  15.  '  

102  644 

Protein  Total 

No.  6                                        Calories  Calories 

Watermelon     5  gO 

Scrambled  Eggs   (equivalent  to  2  eggs)    50  150 

Nut  Tomato  Toast    34  205 

Per  cent  of  protein  for  the  meal,  20.  

89  435 

Here  is  illustrated  a  low  total  with  high  protein. 

Protein  Total 

No.    7                                                                                                       Calories  Calories 

Orange  Juice   (7  oz.)    7  100 

Corn  Flakes  with  Milk   '. 16  100 

Baked  Apple   2  125 

Cottage  Cheese  Omelet 62  170 

Graham  Zwieback  (2) 26  200 

Butter   (thin  pat)    50 

Cereal  Coffee  with  Evaporated  Milk  and  Sugar  ...     8  65 

Per  cent  of  protein  for  the  meal,  14.  — • 

121  810 

Protein  Total 

No.    8                                                                                                       Calories  Calories 

Fruit   (large  apple  or  orange) 6  100 

Oat   Gruel     23  125 

Puree  of  Peas  on  Toast  38  200 

Graham  Puffs.  (2)    29  170 

Butter   (thin  pat)    50 

Per  cent  of  protein  for  the  meal,  14.5. 

96  645 

Protein  Total 

No.    9                                                                                                       Calories  Calories 

Fruit  Salad    20  300 

Milk  Toast   33  200 

Poached  Egg   25  75 

Per  cent  of  protein  for  the  meal,  14. 

78  575 

Butter  is  allowed  in  the  above  menus,  but  it  should 

ever  be  remembered  that  its  use  may  well  be  mini- 
mized and  that  many  times  it  may  be  dispensed  with 
entirely,  to  advantage,  without  lessening  the  palatabil- 
ity  of  the  meal. 


MEAT    SUBSTITUTES  165 

Other  more  simple  breakfasts  may  be  as  follows: 

Protein  Total 

No.   10                                                                                                    Calories  Calories 

Orange  Juice   (7  oz.)    7  100 

Poached  Egg  on  Toast  39  200 

Dates    (6)     4  150 

Per  cent  of  protein  for  meal,  11. 

50  450 

The  calories  for  the  poached  egg  on  toast  include  25 
calories  of  butter. 

Protein  Total 

No.    11                                                                                                    Calories  Calories 

Whole  Grapefruit  with  Honey   7  150 

Shredded  Wheat  with  Milk   32  200 

English  Walnuts   (3)    10  100 

Per  cent  of  protein  for  meal,  11. 

49  450 

Protein  Total 

No.    12                                                                                                    Calories  Calories 

Fruit  Salad    13  181 

Milk  Toast   34  200 

Per  cent  of  protein  for  the  meal,  12.5. 

47  381 

Graham  or  whole-wheat  zwieback  should  be  used  for 
the  toast. 

Protein  Total 

No.    13                                                                                                    Calories  Calories 

Grapefruit  with  Honey    •. 7  150 

Browned  Rice  with  Milk    29  200 

Cream  Rolls  or  Fruit  Crackers   (3)    15  126 

Per  cent  of  protein  for  meal,  11. 

51  476 

With  rather  a  low  per  cent  of  protein  for  breakfast, 
the  dinner  must  be  planned  so  as  to  furnish  a  larger 
per  cent. 

Sample  Dinner  Menus 

Protein  Total 

No.    1                                                                                                       Calories  Calories 

Cream  of  Pea  Soup   28  137 

Zwieback     14  100 

Cottage  Cheese  Omelet    62  170 

Baked   Potato    13  125 

Butter    .  50 


166  THE    HOME   DIETITIAN 

Cauliflower     7  13 

Grated  Carrots    4  20 

Cocoanut  Drop  Cakes    14  158 

Orange  Juice    ( 7  oz. )    7  100 

Per  cent  of  protein  for  the  meal,  17.  

149  873 

Prepare  soup,  omelet,  and  drop  cakes  according  to 
recipes  33,  48,  and  106.  Leave  the  soup  thick  enough 
so  that  any  water  from  the  cauliflower  may  be  added. 
Make  zwieback  from  Graham  or  whole-wheat  bread. 
Use  butter  very  moderately.  Bake  the  cottage  cheese 
omelet  and  potatoes  together,  in  a  low  oven.  The  ome- 
let can  stay  in  until  the  potatoes  are  ready  to  serve. 
Do  not  remove  the  omelet  from  the  oven  until  ready  to 
serve;  then  serve  at  once.  Add  to  the  omelet  the  yolks 
of  the  eggs  used  in  making  the  drop  cakes.  For  each 
individual  salad,  place  in  a  lettuce  leaf  two  or  three 
tablespoonfuls  of  grated  carrots  to  which  a  dressing  of 
lemon  juice  and  salt  has  been  added.  Dilute  the  orange 
juice  very  little,  if  at  all;  add  no  sugar  unless  oranges 
are  very  sour ;  in  this  case  it  will  be  better  to  dilute  the 
orange  juice  with  a  sweeter  fruit  juice,  as  grape  juice, 
bottled  pineapple  juice,  or  the  juice  of  stewed  fruit. 

Protein  Total 

No.   2  Calories  Calories 

Cream  of  Celery  Soup   21  140 

Zwieback     14  100 

Shredded  Lettuce  with  Cream  Dressing  10  55 

Braised   Protose   49  110 

Mashed  Potato  with  Brown  Sauce    21  155 

Asparagus   Tips    8  25 

Stuffed  Dates    (4)    8  136 

Grape  Juice    (7  oz.)    2  100 

Per  cent  of  protein  for  the  meal,  16. 

loo  o^l 

Prepare  soup  and  salad  according  to  recipes  34  and 
78  (omitting  the  tomatoes).  Scrub  the  potatoes  thor- 
oughly before  paring,  and  add  potato  skins  to  the  soup 


MEAT    SUBSTITUTES  167 

stock.  To  make  the  brown  sauce,  use  a  pint  of  the 
broth  from  the  soup  stock,  pouring  it  off  the  top  be- 
fore the  soup  stock  is  put  through  the  colander.  To 
this  brown  liquid  add  a  cup  of  tomato  juice,  thicken 
with  flour  which  has  been  browned  in  a  dry  pan,  and 
salt  to  taste.  Cook  the  tough  asparagus  ends,  and  use 
this  water  for  cooking  the  asparagus  tips.  Add  any 
water  left  from  the  asparagus  to  the  soup  stock. 

Protein  Total 

No.    3  Calories  Calories 

Cream  of  Lima  Bean  Soup    31  146 

Zwieback    ( 2 )    28  200 

Lettuce  and  Tomato  Salad   7  117 

Carrot  and  Nut  Loaf  with  Cream  Sauce  22  147 

Mashed  Turnips   2  7 

Prune  Whip     11  123 

Almonds   (6)    15  100 

Per  cent  of  protein  for  the  meal,  14.  • 

116  840 

Prepare  soup,  salad,  and  carrot  and  nut  loaf  accord- 
ing to  recipes  33,  78,  and  51.  The  egg  yolks  left  from 
the  prune  whip  may  be  beaten  and  added  to  the  soup, 
to  cream  salad  dressing,  or  to  the  carrot  and  nut  loaf. 

Protein  Total 

No.    4  Calories  Calories 

Cream  of  Tomato  Soup   19  112 

Zwieback     14  100 

Shredded  Cabbage  with  Cream  Dressing   10  65 

Cottage  Cheese  with  Cream   40  200 

Stuffed    Potato    15  150 

String    Beans    6  30 

Nuts   and  Raisins    12  150 

Per  cent  of  protein  for  the  meal,  14 %.  

116  807 

Prepare  cream  of  tomato  soup,  salad,  and  stuffed 
potatoes  according  to  recipes  27,  79,  and  61.  Add  the 
water  from  the  string  beans  to  the  soup.  Serve  2 
tablesppons  cottage  cheese  in  individual  dishes  and 
cover  with  cream  or  top  milk. 


168  THE    HOME   DIETITIAN 

Protein  Total 

No.    5  Calories  Calories 

Puree  of  Green  Peas  with  Tomato  Sauce   33  152 

Spinach   with    Egg 20  62 

Boiled   Potatoes    10  100 

Buttermilk    (7    oz.)     28  75 

Almonds   (6)    15  100 

Apple  Pie   16  350 

Per  cent  of  protein  for  the  meal,  15. 

122  839 

Prepare  puree  of  peas  and  sauce  according  to  recipes 
56  and  69.  Serve  spinach  with  sliced  hard-boiled  eggs, 
and  lemon  if  desired.  Before  paring  the  potatoes,  scrub 
them  thoroughly  and  make  a  broth  from  the  skins  to 
add  to  the  tomato  sauce.  The  pie  is  allowed  because 
of  the  simplicity  of  the  meal  and  its  otherwise  high 
protein  content. 

Protein  Total 

No.    6  Calories  Calories 

Browned    Potatoes    19  129 

Protose  Steak  or  Bean  Croquettes    54  192 

Baked   Carrots    9  54 

Combination  Salad  with  Lemon  Dressing    7  35 

Grape   Juice  —  Sweet  Wafers    6  200 

Per  cent  of  protein  for  the  meal,  15%. 

95  610 

Follow  recipes  in  Chapter  XXXI.  The  skins  of  the 
potatoes  should  be  boiled  and  the  broth  added  to  the 
sauce  for  the  browned  potatoes. 

Protein  Total 

No.   7  Calories  Calories 

Cream  of  Corn  Soup    18  135 

Fresh   Tomatoes    (or   Stewed)     7  33 

Baby   Limas    24  115 

Baked  Hubbard   Squash    3  43 

Milk    (7  oz.)    28  140 

Caramel    Pudding    5  148 

Per  cent  of  protein  for  the  meal,  14. 

85  614 

Prepare  soup  and  pudding  according  to  recipes  30 
and  107. 


MEAT    SUBSTITUTES  169 

Protein  Total 

No.    8                                                                                                       Calories  Calories 

Cream  of  Spinach  Soup   .........................   21  93 

Zwieback    (1)    ................  '.  ..................  14  100 

Cottage  Cheese  and  Nut  Roast  with  Cream  Sauce  40  200 

Baked  Sweet  Potatoes   ...........................  12  206 

Celery    (3   stalks)    ...............................     5  20 

Olives    (5)    ......................................     5  100 

Fruit  Salad   .....................................  11  156 

Per  cent  of  protein  for  the  meal, 


lUo  oTo 

For  soup,  roast,  and  salad,  use  recipes  35,  49,  and  74. 

Protein  Total 

No.   9  Calories  Calories 

Vegetable   Bouillon    ..............................   24  93 

Zwieback    (1)    ............................  .......   14  100 

Carrot  and  Nut  Salad   ...........................  11  61 

Eggplant    Croquettes     ..............  .  .............   18  110 

Green   Peas    .....................................   24  95 

Banana  Snow    ...................................  15  91 

Cereal  Coffee  with  Evaporated  Milk  and  Sugar   ...     8  65 

Per  cent  of  protein  for  the  meal,  18. 

114  615 

For  vegetable  bouillon,  use  recipe  37,  or  the  water 
from  any  cooked  vegetable.  Prepare  croquettes  and 
banana  snow  according  to  recipes  52  and  98.  To  make 
each  individual  salad,  grate  an  average  carrot  and  add  to 
it  two  or  three  nuts  chopped.  Serve  on  a  lettuce  leaf 
with  lemon  dressing. 


It  can  be  seen  readily  from  the  above  menus  that 
the  per  cent  of  protein  can  be  very  easily  varied.  In 
this  way  the  protein  balance  may  be  adjusted  accord- 
ing to  the  needs  of  the  individual  and  to  circumstances. 
With  a  breakfast  and  dinner  both  high  in  protein,  the 
third  meal  need  contain  little,  if  any,  as  when  only 
fruit  is  taken.  Even  with  the  low  total  of  600  calories, 
as  in  No.  9,  it  is  possible  to  so  adjust  the  protein  bal- 
ance that  the  person  who  needs  only  a  low  total  may 


170  THE    HOME   DIETITIAN 

still  get  his  100  or  more  of  protein  for  the  meal.  The 
servings,  of  course,  may  be  increased,  and  the  value 
easily  calculated. 

Meats  are  so  commonly  used  in  the  making  of  sand- 
wiches, and  sandwiches  are  often  so  pleasing  and  prac- 
tical a  means  of  serving  food  for  lunches,  picnics,  etc., 
that  this  chapter  would  hardly  seem  complete  without 
a  few  suggestions  as  to  satisfactory  meatless  sandwich 
filling. 

There  is  no  reason  why  the  dark  breads  as  well  as 
white  should  not  be  used  for  sandwiches.  The  slices 
should  be  cut  thin  and  the  hard  upper  crust  may  be 
removed,  care  being  taken  that  it  is  not  wasted,  but 
saved  to  make  zwieback  strips,  croutons,  or  zwieback 
crumbs.  The  bread  may  or  may  not  be  buttered,  de- 
pending upon  the  nature  of  the  filling.  As  a  general 
thing,  fillings  that  supply  protein  are  rather  better 
than  those  that  furnish  a  preponderance  of  sweet,  un- 
less the  protein  has  been  well  supplied  in  some  other 
way.  Usually  an  occasion  for  sandwiches  means  plenty 
of  sweets  in  some  other  form,  as  cake,  ice  cream,  etc. 

Egg,  cottage  cheese,  and  peanut  butter  sandwiches 
are  always  good,  and  may  be  a  help  in  supplying  the 
protein  part  of  the  child's  school  lunch.  Among  other 
satisfactory  fillings  are  the  following: 

1.  Nut  Tomato  Sandwich 

Emulsify  peanut  butter  with  strained  tomato, 
salt  slightly.  Use  the  same  as  plain  peanut 
butter. 

2.  Cottage  Cheese  Tomato  Sandwich 

Add  to  cottage  cheese  enough  strained  tomato 
to  make  it  the  proper  consistency.  Mix  well. 
Use  with  a  lettuce  leaf  for  sandwich  filling. 


MEAT    SUBSTITUTES  171 

3.  Carrot  Cottage  Cheese  Sandwich 

Make  filling  according  to  recipe  77. 

4.  Bean  Sandwich 

Press  beans  through  a  colander,  add  salt  and 
a  little  lemon  juice.  Use  for  sandwich  filling. 

5.  Lentil  Sandwich 

Prepare  as  No.  4. 

6.  Green  Pea  Sandwich 

To  pea  puree  add  a  little  evaporated  milk,  salt, 
and  use  as  filling. 

7.  Protose  Sandwich 

Remove  protose  from  can,  mash,  add  lemon 
juice  and  salt,  mix  well,  and  use. 

8.  Protose  and   Nuttolene  Sandwich 

Prepare  as  in  No.  7,  using  eq'ual  parts  of  pro- 
tose and  nuttolene. 

9.  Lettuce  Sandwich 

Spread  buttered  bread  with  mayonnaise,  and  use 
lettuce  leaf  for  filling. 

10.  Celery  Sandwich 

Steam  bread,  then  butter,  roll  around  a  celery 
stalk,  and  tie  the  roll  with  baby  ribbon.  Serve 
as  soon  as  possible. 

11.  Tomato  Sandwich 

Spread  buttered  bread  with  mayonnaise,  and  use 
large  slice  of  tomato  for  filling. 

12.  Salad  Sandwich 

Chop  lettuce,  tomato,  radishes,  celery,  carrots, 
or  any  other  raw  vegetable,  all  together,  mix 
with  mayonnaise,  and  use  for  filling. 


CHAPTER  XX 
COMBINATIONS 

The  Solution 

THE  question  of  proper  and  hygienic  combinations  of 
food  is  one  which  greatly  exercises  the  mind  of  many 
who  find  it  necessary  to  consider  their  diet  from  a 
health  viewpoint.  Yet  we  believe  that  those  who  have 
carefully  followed  us  in  our  discussion  of  the  previous 
chapters  can  readily  see  that  when  the  daily  ration  is 
properly  balanced,  and  one  is  careful  not  to  overeat, 
the  problem  of  food  combination  is  to  a  great  extent 
solved.  And  again  we  are  reminded  of  the  beauty  and 
freedom  of  eating,  as  well  as  living,  by  principle 
rather  than  merely  by  rule.  However,  there  are  a  few 
points  in  this  connection  which  perhaps  should  be 
spoken  of  in  addition  to  those  already  discussed. 

Small  Variety 

First,  and  perhaps  most  important  of  all,  is  this:  the 
menu  having  been  properly  balanced,  it  is  much  better 
to  serve  a  small  variety  at  one  meal.  A  large  variety 
often  complicates  the  digestive  processes  and  tends  to 
overeating.  Different  kinds  of  digestive  juices  are 
called  forth  by  different  foods.  If  the  variety  is  too 
great,  the  stomach  may  find  it  difficult  or  impossible  to 
manufacture  so  many  kinds  of  gastric  juice  at  the  same 
time,  and  thus  the  digestive  process  be  hindered. 

Often  when  some  particular  food  disagrees,  it  can  be 
eaten  and  properly  digested  if  taken  unmixed  with 
other  foods.  This  is  sometimes  true  in  cases  where 
fruit  is  not  well  taken.  Although  fruit  should  form  a 
part  of  the  dietary  of  every  one,  yet  there  are  those 

172 


COMBINATIONS  173 

who  seem  unable  to  take  it  in  any  form,  particularly  if 
raw,  or  very  acid.  In  nearly  every  case  if  these  persons 
would  devote  one  meal  to  the  eating  of  fruit  and  noth- 
ing else,  they  would  find  themselves  able  to  eat  it  with- 
out trouble,  and  they  would  often  soon  find  it  possible 
to  add  one  other  simple  food  to  the  fruit  meal,  such  as 
oven  toast  or  cereal  in  some  form. 

Fruit  and   Vegetables 

The  combination  of  fruit  and  vegetable  is  not  an 
ideal  one.  Fruit,  being  a  predigested  food,  should  pass 
from  the  stomach  very  soon  after  entering  it.  Vegeta- 
bles often  require  rather  a  prolonged  stomach  digestion 
because  of  the  protein  which  they  contain.  The  cellu- 
lose of  either  fruit  or  vegetable  is  usually  all  the  cellu- 
lose the  stomach  should  be  called  upon  to  handle  at 
one  time,  unless,  of  course,  either  is  in  very  small 
amounts.  The  fruit  cellulose  in  addition  to  that  con- 
tained in  the  vegetable  may  greatly  retard  and  even 
prevent  the  digestion  of  the  vegetable  protein.  This 
objection  is  to  a  great  extent  removed  if  the  fruit  is 
served  in  the  form  of  a  puree,  the  cellulose  removed  as 
in  prune  or  apple  whip,  fruit  mold,  etc.,  or  if  the  vege- 
tables are  tender,  free  from  fibrous  cellulose,  and  easy 
of  digestion.  There  is  ordinarily  no  objection  to  fruit 
juices  taken  at  meals  where  vegetables  are  served. 

Starch  and  Acids 

Much  has  been  said  in  regard  to  the  combination  of 
starches  and  acids,  the  reason  being  given  that  the 
ptyalin  of  the  saliva,  which  acts  upon  starch,  does  its 
work  only  in  an  alkaline  medium,  the  saliva  normally 
being  slightly  alkaline.  However,  as  all  our  food,  ex- 
cept meat  and  nuts,  contains  starch,  this  would  inter- 
dict the  eating  of  fruits  with  any  food  ordinarily 
served.  Even  cottage  cheese  and  buttermilk,  with  their 


174  THE    HOME   DIETITIAN 

lactic  acid  content,   would  have  to  be  eaten   by  them- 
selves. 

Starch  digestion  is  carried  on  to  a  great  extent,  in  the 
small  intestine,  and  if  the  process  of  mastication  is 
thorough  enough  to  finely  divide  the  food,  there  need 
be  little  concern  as  to  the  chemical  digestion  of  starch. 
As  a  matter  of  fact,  fruit  acids  in  the  mouth  stimulate 
the  secretion  of  a  very  strongly  alkaline  saliva. 

Milk  and   Sugar 

The  milk  and  sugar  combination  has  already  been 
spoken  of,  and  while  it  is  perhaps  not  necessary  to 
avoid  it  entirely,  it  should  be  remembered  that  milk 
and  sugar  combined  in  excessive  quantities  may  prove 
very  injurious,  and  for  one  with  a  weak  digestion 
should  be  avoided. 

Fruit   and   Milk 

Whether  or  not  milk  and  fruit  should  be  taken  at  the 
same  meal,  depends  largely  on  how  they  are  taken. 
We  quote  as  follows: 

"  There  is  a  deep-rooted  impression  that  sweet  milk 
and  fruit  should  not  be  taken  at  the  same  meal.  This  idea 
is  evidently  largely  based  upon  the  fact  that  milk  cur- 
dles in  the  presence  of  a  fruit  acid;  but  the  curdling 
of  the  milk  by  the  fruit  acid  aids  rather  than  retards 
its  digestion.  The  first  thing  that  happens  to  milk 
wrhen  it  reaches  the  stomach  is  that  it  is  curdled. 
There  is  a  special  milk-curdling  ferment  in  the  stom- 
ach. A  fruit  juice  more  acid  than  the  normal  gastric 
juice  of  the  stomach  cannot  be  found.  Lemon  juice, 
one  of  the  most  acid  of  fruit  juices,  added  to  milk, 
renders  the  milk  easier  of  digestion.  We  should  guard 
against  the  sudden  pouring  of  a  large  quantity  of  milk 
into  the  stomach,  as  this  may  form  large,  tough  curds, 
difficult  of  digestion.  If  the  milk  is  taken  slowly,  or 


COMBINATIONS  175 

mixed  with  the  food  as  it  enters  the  stomach,  it  will  be 

converted  into  small  curds."- -George  Thomason,  M.  D. 

Experiments  seem  to  show  that  it  is  the  mixing  with 

the  food  rather  than  the  sipping  that  prevents  large  curds. 

Medicinal  Value  of  Fruit 

It  is  well  to  remember  that  fruit  is  practically  pre- 
digested,  and  quickly  passes  from  the  stomach,  unless 
combined  with  a  food  requiring  prolonged  stomach  di- 
gestion. For  this  reason  some  may  find  it  an  advantage 
to  eat  the  fruit  part  of  their  meal  first,  thus  allowing  it 
time  to  pass  from  the  stomach  before  a  great  deal  in  the 
way  of  other  food  follows.  Still  others,  as  suggested 
above,  find  it  better  to  eat  their  fruit  alone,  uncombined 
with  other  foods.  The  full  medicinal  value  of  fruit  is  best 
obtained  by  taking  it  on  an  empty  stomach.  Ordinarily, 
however,  milk  eaten  on  cereal  or  mixed  with  other  food 
need  interfere  in  no  way  with  the  taking  of  fruit  with 
the  same  meal.  Boiled  milk  does  not  form  large  curds, 
so  is  more  quickly  digested  than  raw  milk  and  less 
liable  to  hinder  the  digestion  of  any  other  food  with 
which  it  may  be  combined.1  It  should  be  remembered 


"  Brennemann  emphasizes  the  following  facts :  '  Cow's  milk  is  not  a  liquid 
food,  but  a  solid  food  —  so  solid,  in  fact,  that  in  babies  the  curds  found  in  the 
stomach  often  pass  through  the  intestinal  tract  and  appear  in  the  stools  as  tough, 
hard,  beanlike  curds.' 

"  The  summary  of  his  experiments  shows  that  raw  milk  skimmed,  forms  hard, 
rubbery  masses,  not  easily  broken.  That  with  whole  milk  the  masses  are  tough 
and  leathery,  but  not  to  the  same  extent  as  skimmed  milk.  The  use  of  top  milk 
made  the  curds  somewhat  softer,  but  delayed  digestion  considerably.  The  use  of 
boiled  milk  resulted  in  the  curds  being  fine  and  more  flocculent,  no  tendency  to 
form  masses,  as  does  raw  milk.  The  length  of  time  for  complete  emptying  of  the 
stomach  was  somewhat  shorter  in  the  case  of  boiled  milk.  Another  very  interest- 
ing point  he  noted  was,  that  smaller  curds  of  raw  milk  had  a  tendency  to  coalesce 
and  form  large  masses.  This  feature  was  made  use  of  in  one  experiment  in  which 
he  had  the  subject  sip  one  quart  of  raw  milk  over  a  period  of  forty-five  minutes,  and 
thirty  minutes  later  he  tried  to  return  the  milk,  but  was  able  to  get  only  the  whey. 
Five  hours  later  he  was  unable  to  get  anything  more  until  he  had  used  two  glasses 
of  water,  then  only  a  few  small  curds.  But  during  that  time  the  subject  com- 
plained of  a  "  heavy  feeling  "  in  the  pit  of  the  stomach.  The  experiment  was  per- 
formed several  times,  with  the  same  results,  then  was  done  in  an  open  dish,  using 
Chymogen  (a  rennet  preparation),  gently  stirring  all  the  time,  and  over  a  period 
of  more  than  an  hour.  The  results  were  a  complete  coagulation  into  two  large 
masses  which  could  not  be  broken  up.  His  conclusions  were  that  this  same  process 
occurred  in  the  stomach  and  that  the  idea  of  taking  milk  in  small  sips  to  prevent 
the  formation  of  large  curds  in  the  stomach  was  fallacious,  because  the  curds  had 
some  sort  of  affinity  for  each  other  and  would  form  larger  masses."  • —  Reprinted 
from  an  article  by  Dr.  A.  J.  Scott,  Jr.,  in  the  Southern  California  Practitioner, 
February,  1920. 


176  THE   HOME   DIETITIAN 

that  thorough  mastication  will  prevent  the  unpleasant 
results  which  sometimes  seem  to  follow  the  introduction 
of  unlike  foods  into  the  stomach.  More  often  incom- 
plete mastication,  rather  than  the  nonideal  combination, 
leads  to  fermentation. 

Two  Starches 

Another  rule  in  regard  to  combinations  that  has  been 
given  is  the  one  that  two  starches  should  not  be  eaten 
at  the  same  meal,  or  that  bread  must  not  be  eaten  with 
a  starchy  food.  However,  as  so  many  of  our  foods 
contain  starch,  the  following  of  this  rule  would  be  quite 
impractical.  The  principle  underlying  it  obviously  in- 
volves the  question  of  the  proper  food  balance.  This 
having  been  looked  after  by  the  intelligent  housewife 
in  the  planning  of  the  meal,  the  question  of  whether 
or  not  two  or  more  foods  containing  starch  should  be 
combined  can  be  forgotten.  It  can  readily  be  seen  that 
a  meal  composed  of  rice  and  potatoes,  with  white  bread, 
would  be  far  from  correct  healthwise,  but  this  mistake 
no  one  who  understands  the  fundamentals  of  dietetics 
will  make. 

Two  Kinds  of  Fruit 

Some  one  else  raises  the  question,  "  Should  two  kinds 
of  fruit  be  eaten  at  one  meal,  or  is  it  healthful  to  eat 
stewed  fruit  and  fresh  fruit  at  the  same  time  ?  "  We 
know  of  no  reason  why  these  combinations  are  objec- 
tionable, and  again  we  would  emphasize  the  importance 
of  getting  away  from  petty  rules  and  of  intelligently 
planning  the  daily  dietary,  combining  common  sense 
and  good  judgment  with  a  knowledge  of  scientific  prin- 
ciples. Eat  a  few  well-selected  foods  at  one  meal.  Do 
not  overeat  or  undereat,  but  see  that  the  foods  are  so 
prepared  and  combined  in  the  daily  ration  that  the 
necessary  food  elements  in  proper  proportion  and  amount 
are  supplied  to  the  body. 


COMBINATIONS  177 

Drinking  at  Meals 

Drinking  at  meals  may  well  be  mentioned  here.  The 
contents  of  the  stomach  are  liquid;  food,  when  prop- 
erly masticated,  approaches  a  liquid  state.  The  more 
nearly  homogeneous,  or  thoroughly  mixed,  this  food 
mass  is,  the  greater  the  ease  of  digestion.  The  semi- 
liquid  food  mass  must  be  gripped  by  the  muscular  wall 
of  the  stomach  and  thoroughly  permeated  by  and  mixed 
with  the  gastric  juice,  and  as  an  evenly  divided  homo- 
geneous liquid,  enter  the  intestine.  Liquid  sipped,  or 
taken  in  spoonfuls,  and  mixed  with  other  food  as  it  is 
taken,  may  facilitate  this  result,  but  if  taken  in  quan- 
tities unmixed  with  food,  it  may  overdistend  the  stom- 
ach and  enfeeble  its  muscular  grip.  If,  at  the  same 
time,  chunks  of  incompletely  masticated  food  are  swal- 
lowed, the  stomach  may  have  to  deal  with  a  veritable 
pond  in  which  more  or  less  solid  masses  of  food  are 
floating,  making  the  proposition  of  resolving  it  all  into 
a  well-mixed  mass,  a  very  difficult  one.  Housewives 
well  know  that  in  mixing  water  with  semisolid  food 
material  it  is  much  easier  when  the  water  is  added 
gradually,  and  just  so  it  is  in  the  stomach.  If  at  the 
same  time  the  gastric  juice  is  greatly  diluted  by  an  excess 
of  fluid,  the  chemical  phase  of  digestion  may  be  hindered. 

When  a  large  amount  of  concentrated  food  is  being 
ingested,  some  water  taken  with  the  meal  may  be  an 
advantage,  and  occasionally,  as  after  exercise,  when 
thirst  demands  a  drink  of  water  at  mealtime,  the  pres- 
ence of  a  systemic  need  for  water  may  cause  the  ex- 
cess of  fluid  to  be  very  quickly  absorbed.  Fluid  taken 
at  meals  should  never  interfere  with  thorough  mast 
cation.  With  these  principles  in  mind,  the  questio 
of  water  drinking  at  meals  must  be  decided  by  the  in- 
dividual, as  indeed  should  all  dietetic  rules.  The  prin- 
ciple, not  the  rule,  must  ever  be  the  guide. 

12 


CHAPTER  XXI 
THE  FEEDING  OF  CHILDREN 

IT  is  in  childhood  that  the  foundation  for  the  health 
or  ills  of  life  is  laid,  and  more  can  be  accomplished  by 
proper  feeding  of  the  boys  and  girls  while  yet  in  the 
developmental  stage  than  in  after-years  when  the  seeds 
of  ill  health  have  long  been  sown  and  nature  has  begun 
to  take  her  toll.  Careful  feeding  can  do  much  to  pre- 
vent the  digestive  upsets  and  respiratory  troubles  so 
common  among  children,  and  will  lay  a  foundation  for 
health  and  strength  in  after-life  that  means  more  than 
any  heritage  of  lands  or  gold. 

Normal  Physical  Growth 

We  cannot  in  our  limited  space  present  an  exhaustive 
treatise  on  this  important  phase  of  dietetics,  but  we 
can  lay  down  a  few  principles  that  may  serve  as  a  help- 
ful guide  in  the  important  work  of  supplying  to  the  child 
the  food  which  will  yield  happy  results  in  the  way  of 
a  normal  physical  growth.  The  body  is  made  up  of  the 
food  supplied  to  it.  This  food  should  be  complete, 
untainted  by  impurities  introduced  from  without  or 
manufactured  from  within. 

Regularity 

Perhaps  one  of  the  most  important  things  to  be  made 
emphatic  is  the  necessity  for  regularity  in  feeding,  with 
ample  length  of  time  between  meals  for  the  stomach  to 
entirely  empty  itself.  We  find  that  even  infants  do  much 
better  when  fed  every  three  or  four  hours,  than  when 
fed  every  two  hours,  as  has  so  commonly  been  done. 
They  gain  in  weight  more  rapidly,  have  less  colic,  and 
are  happier  in  every  way. 
178 


FEEDING    OF    CHILDREN  17$ 

A  Precaution 

When  it  is  necessary  to  feed  babies  artificially,  it  is 
safer  to  use  only  sterilized  milk.  It  has  been  found, 
too,  that  the  boiling  of  milk  greatly  increases  its  diges- 
tibility.1 However,  if  the  milk  is  boiled  or  even  Pas- 
teurized, it  is  of  the  greatest  importance  that  these 
babies  receive  in  addition  to  their  milk,  at  least  an  ounce 
of  orange  juice  daily;  a  neglect  of  this  precaution  often 
being  a  factor  in  nutritional  disturbances,  such  as 
scurvy,  eczema,  rickets,  etc.  (See  Chapter  IX.)  Orange 
juice  may  be  introduced  carefully  into  their  diet  at  any 
time  after  the  age  of  one  month,  and  it  is  often  a  valu- 
able addition  to  the  diet  of  even  a  nursing  infant. 

If  the  baby  does  not  take  orange  juice  well  or  if  this 
fruit  is  difficult  to  obtain,  the  necessary  vitamines  may 
be  supplied  in  potato  water  or  in  other  vegetable  broths. 
Other  fruit  juices  may  be  used,  as  lemon  juice  or  grape- 
fruit juice,  or  the  juice  of  canned  tomatoes  may  be  given. 

After  Seven  Months 

It  is  well,  after  the  age  of  seven  months,  gradually 
to  introduce  into  the  diet  additional  foods,  as  vegetable 
broths  and  purees,  potato  gruel,  and  cereal  gruels.  To 
make  the  cereal  gruels,  the  cereals  should,  after  thorough 
cooking,  be  put  through  a  colander  or  strainer,  and  to 
the  jelly-like  mass  left  should  be  added  milk  (not  cream) 
to  make  it  the  consistency  of  gruel.  Add  no  sugar. 

The  Second  Year  —  Importance  of  Vegetables 

A  little  later,  or  by  the  age  of  nine  months,  vegetable 
purees,  oven  toast,  hard  crackers,  and  scraped  apple  or 
apple  sauce  should  be  given;  also  other  fruit  purees  and 
fruit  juices.  Early  in  the  second  year  the  child  should 

1  According  to  Dennett,  the  milk  or  milk  mixture,  the  proportion  depending  upon 
the  baby'a  age,  should  be  boiled  vigorously  for  three  minutes,  stirring  well  to  pre- 
vent the  formation  of  a  scum.  The  curds  formed  from  this  milk  are  fine  and  much 
like  those  of  mother's  milk,  and  when  properly  supplemented  with  orange  juice  and 
vegetable  broths,  are  not  constipating. 


180  THE    HOME   DIETITIAN 

begin  to  have  green  vegetables,  as  spinach,  green  peas, 
string  beans,  etc.  These  should  be  pureed  at  first,  but 
soon  the  child  may  be  taught  to  masticate  thoroughly 
the  more  tender  cellulose,  so  that  tender,  carefully  cooked 
vegetables  may  be  given  without  being  strained  or  pu- 
reed. This  early  training  to  like  vegetables  is  of  great 
importance. 

Milk  is  ever  a  very  important  food  for  children,  and 
throughout  childhood  a  quart  of  milk  daily  may  well 
form  the  basis  of  the  diet.  Milk  may  be  considered  a 
safeguard  against  conditions  arising  from  a  denci 
diet.  However,  as  important  as  it  is,  it  should  not  be 
allowed  to  crowd  out  other  important  foods,  especially 
the  leafy  vegetables.  One  mistake  that  is  often  made  is 
in  keeping  children  too  long  on  milk  alone,  some  babies 
being  nursed  into  the  second  year  or  kept  upon  the  bottle 
long  after  they  should  be  having  a  greater  variety  of 
food. 

Cereals  Without  Sugar 

The  cereals  will  during  the  second  year  have  an  im- 
portant place  in  the  diet  of  the  child,  along  with  milk 
toast  and  stale  bread  and  milk.  In  the  beginning  of  the 
second  year,  well-cooked  cereals  may  be  given  the  child 
without  the  preparatory  process  of  straining.  These 
cereals  should  be  thoroughly  cooked.  The  mistake  is 
often  made  of  adding  sugar  to  the  cereal,  but  the  child 
should  learn  from  the  first  to  take  cereal  and  milk 
without  sugar.  Great  harm  is  done  by  educating  chil- 
dren to  like  sugar  in  this  way.  Never  at  any  time 
should  the  combination  of  milk  and  sugar  be  allowed 
on  cereal,  whether  gruel  or  mush. 

Bread  should  be  whole  wheat  and  Graham,  or  made 
from  other  whole  grains,  and  should  be  at  least  thirty- 
six  hours  old.  All  toast  given  the  child,  whether  dry 
or  as  milk  toast,  should  be  in  the  form  of  oven  toast, 


FEEDING   OF    CHILDREN  181 

hard  clear  through.  Ordinarily,  after  six  months  the 
daily  feedings  should  be  four,  at  four-hour  intervals,  and 
the  sooner  after  the  age  of  twelve  months  that  a  child 
is  put  on  three  meals  a  day  the  better,  with  orange 
juice  and  perhaps  other  fresh  fruit,  as,  for  example, 
a  scraped  apple,  between  meals. 

Sweets 

Artificial  sweets  should  be  limited.  (See  Chapter  VIII, 
p.  66,  quotation  from  Dr.  Kerley.)  It  were  better  for 
any  child  if  he  need  never  know  of  the  existence  of  cake, 
pie,  ice  cream,  and  ordinary  desserts.  It  is  only  as  a 
result  of  education  that  children  acquire  the  sweet  tooth 
so  common  among  them.  But  it  can  hardly  be  hoped 
that  the  ideal  will  be  reached  —  there  are  too  many  lov- 
ing friends  to  teach  our  children  to  like  these  things  for 
us  to  expect  to  be  able  to  keep  sweets  entirely  away 
from  them.  If  the  sweets  could  be  limited  to  their 
proper  place  and  to  that  alone,  no  harm  perhaps  might 
be  done,  but  with  the  knowledge  of  the  delight  to  the 
palate  comes  the  difficulty  of  teaching  proper  control 
and  moderation.  However,  this  must  be  done,  and  our 
aim  as  parents  must  be,  if  not  to  restrict  entirely,  to 
limit  candy  and  other  sweets  to  the  proper  time,  place, 
and  amount.  Much  can  be  done  in  this  direction,  and 
it  is  surprising  how  much  co-operation  can  be  elicited 
from  the  little  folks  if  they  are  taught  in  the  interesting 
way  that  it  is  possible  for  them  to  be  taught,  the  im- 
portance of  caring  for  the  body  machine  as  carefully  as 
father  looks  after  his  watch  or  his  automobile. 

Self -Control 

The  element  of  education  and  discipline  entering  into 
this  phase  of  child  culture  gives  the  parents  the  great 
opportunity  of  obtaining  results  not  only  in  a  physical 
way,  but  also  in  the  way  of  character  building  and 


182  THE    HOME   DIETITIAN 

control,  so  closely  is  the  physical  allied  to  the  intellectual 
and  moral. 

But  it  is  only  as  the  mother  has  mastered  for  herself 
the  problem  of  eating  for  health  and  the  necessary  self- 
control  to  reach  this  high  ideal,  that  she  can  be  master 
of  the  important  work  of  feeding  and  teaching  her  child. 

Generosity 

The  dainty  morsel  of  candy  can  be  eaten  as  dessert, 
and  when  the  little  one  has,  with  a  hearty  appetite, 
eaten  well  of  the  dinner  served,  a  very  small  amount 
of  candy  will  suffice.  Then  too,  as  a  matter  of  polite- 
ness, the  supply  of  sweets  must  be  passed  and  divided 
with  the  members  of  the  family,  and  in  this  way  the 
amount  may  be  quite  easily  limited  to  the  one  or  two 
pieces  the  child  may  be  allowed  to  have.  With  great 
care  should  the  mother  prepare  the  simple  dessert  al- 
lowed her  tiny  man,  that  there  may  be  nothing  served 
him  that  would  in  any  way  detract  from  the  benefit  his 
little  body  should  derive  from  this  food. 

Simple  Desserts 

Cereal  desserts  made  with  cereal,  egg,  and  a  moder- 
ate amount  of  sugar  are  often  good  (see  recipes,  Chap- 
ter XXXI),  and,  served  at  the  midday  meal,  simply  add 
more  calories  that  the  growing  child  may  thrive.  Des- 
serts such  as  prune  whip,  banana  whip,  junket,  fruit 
mold  (see  recipes,  Chapter  XXXI),  are  all  good  and 
supply  the  necessary  sweet.  The  little  one  will  delight 
in  these  simple  things  if  they  are  made  attractive,  and 
he  will  derive  only  benefit  from  them.  Dried  fruits,  as 
figs,  dates,  raisins,  etc.,  may  help  to  supply  the  needed 
sweet  in  a  very  wholesome  form. 

Fresh  Fruits 

The  child  should  have  fresh  fruit  daily,  which  will 
be  delighted  in  for  its  own  flavor,  if  a  little  tact  is 


FEEDING   OF    CHILDREN  183 

used  by  the  thoughtful  mother.  The  sliced  peaches, 
berries,  and  other  fresh  fruit  served  may  be  enjoyed 
without  the  sugar  usually  added.  Special  care  should 
be  taken  that  this  fruit  be  naturally  sweet  and  pala- 
table. The  children  will  enjoy  honey,  instead  of  sugar, 
on  their  grapefruit  and  it  will  be  better  for  them. 
(See  page  212.)  The  older  members  of  the  family  may 
in  their  interest  in  watching  the  beautiful  development 
of  this  normal  boy  or  girl,  become  enthusiastic  in  eating 
as  carefully  as  the  little  folks  are  taught  to  eat,  and  thus 
become  examples,  incidentally  deriving  immense  advan- 
tage to  themselves. 

Ice   Cream 

A  taste  for  ice  cream  should  not  be  cultivated  early. 
As  the  child  grows  older  it  may  seem  almost  impossible 
to  withhold  it  entirely,  but  it  must  be  insisted  upon 
that  it  be  eaten  only  at  mealtime,  that  it  take  the  place 
of  real  food,  and  that  it  be  eaten  slowly  and  in  moder- 
ation. Too  much  cannot  be  said  against  the  pernicious 
custom  of  permitting  the  child  to  obtain  ice-cream  sodas 
and  ice-cream  cones  promiscuously  from  any  and  every 
ice-cream  stand.  This  tempting  sweet  should  be  ob- 
tained from  a  source  that  guarantees  its  freshness  and 
purity,  and  served  with  care,  preferably  at  the  regular 
meal. 

Cake 

A  simple  sponge  cake  or  plain  cooky  may  be  allowed 
in  place  of,  or  in  connection  with,  the  dessert. 

At  bread-making  time  a  crusty,  sweet  cake  can  be 
made  from  the  bread  dough  that  will  be  as  much  a  de- 
light to  the  normally  educated  child  as  a  French  pastry 
to  the  one  who  has  been  trained  to  like  excessive  and 
rich  sweets.  When  pie  is  served  the  older  members, 
how  the  little  one  will  rejoice  in  a  tiny  pie  made 


184  THE   HOME   DIETITIAN 

cially  for  his  or  her  benefit,  and  the  crust  may  be  as 
hygienic  as  bread,  for  it  may  be  made  from  the  same 
dough,  and  its  palatability  will  never  be  questioned  by 
the  small  recipient. 

Concentrated  Food 

Another  common  mistake  in  feeding  children  is  in 
the  thought  that  they  must  have  an  abundance  of  fat 
—  cream  on  their  cereal,  butter  freely  on  bread,  richly 
seasoned  vegetables,  and  even  fried  and  greasy  foods. 
This  plan  for  them  does  untold  harm,  and  their  ap- 
petites are  so  educated  that  they  can  never,  perhaps,  get 
away  from  the  bondage  of  acquired  and  perverted  tastes. 
Dr.  Kerley  says  that  "  the  average  child  after  the  sixth 
year  receives  two  or  three  times  as  much  energy  food 
as  he  requires."  (This  statement  probably  does  not 
include  the  poorer  classes.)  Energy  food  we  know  to 
be  fat  and  carbohydrate. 

Undesirable  Results 

In  almost  every  case  whole  milk  is  better  than  cream. 
The  child  needs  ample  protein,  but  not  an  excess  of  fat. 
The  catarrhal  conditions,  frequent  colds,  enlarged  ton- 
sils, adenoids,  and  recurrent  bronchitis  so  common 
among  children  undoubtedly  are  favored,  if  not  caused, 
by  the  excess  of  fat  given  them,  together  with  the  large 
amount  of  sweets  allowed  in  their  diet.  The  result  of 
these  mistakes  is  never  entirely  overcome,  and  thus 
the  individual  goes  through  life  handicapped  because  of 
the  ignorance  of  his  parents. 

A  Corrective  Diet 

For  a  child  subject  to  colds,  no  plan  is  better  than  a 
diet  limited,  for  a  time  at  least,  to  boiled  skim  milk, 
whole  cereals,  green  vegetables,  fruits,  cottage  cheese, 
buttermilk,  vegetable  broths,  and  vegetable  soups  (see 


FEEDING    OF    CHILDREN  185 

recipes  23  to  31,  Chapter  XXXI),  with  perhaps  an 
occasional  egg.  Butter  used  very  moderately  if  at  all. 
Above  all  things,  do  not  serve  your  children  hot  fresh 
bread,  griddle  cakes,  fried  potatoes,  richly  seasoned 
foods  of  any  kind. 

To  Encourage  Mastication 

Give  the  children  plenty  of  food  requiring  thorough 
mastication,  as  hard-tack,  oven  toast,  etc.  Teach  them 
to  masticate  thoroughly.  Impress  upon  their  minds  that 
if  they  are  to  have  beautiful,  sound  teeth,  these  teeth 
must  be  exercised  as  well  as  kept  clean.  Tell  them  how 
the  starch  is  changed  to  sugar  in  the  mouth.  Let  them 
become  interested  in  seeing  how  much  sugar  they  can 
manufacture  out  of  a  crust  of  bread  and  how  sweet 
the  sugar  will  taste.  The  social  element  at  mealtime 
may  be  one  of  the  best  safeguards  against  too  rapid 
eating  and  improper  mastication. 

We  quote  the  following: 

"  After  the  teeth  begin  to  come,  children  should  be 
given  all  their  starchy  food  in  as  hard  a  form  as  pos- 
sible and  the  per  cent  of  starch  limited. 

"  The  preponderance  of  the  carbohydrates  in  the  diet 
is  one  of  the  causes  of  so  many  children  entering  the 
kindergarten  with  their  teeth  broken  down  to  the  gums 
and  small  undersized  jaws.  One  of  our  responsibilities 
is  spreading  the  knowledge  that  no  demineralized  white 
bread  or  crackers  should  ever  be  given  to  a  child  under 
five.  We  not  only  need  all  the  lime  salts  contained  in 
the  dark  breads  to  build  the  teeth  and  bones,  but  we 
need  exercise  to  develop  the  jaws. 

"  Children  who  eat  tough  bran  bread  made  into  toast 
instead  of  mush,  and  who  do  not  drink  while  eating, 
usually  get  the  proper  development  of  the  jaws."--M. 
Evangeline  Jordan,  D.  D.  S.,  in  California  State  Health 
Bulletin. 


186  THE   HOME   DIETITIAN 

Co-operation 

Children  must  never  be  allowed  to  drink  tea  or  coffee ; 
even  cocoa  should  be  kept  away  from  them.  They  are 
much  better  off  without  meat  and  meat  broths  with  their 
protein  wastes.  It  is  well  for  the  child  up  to  the  age  of 
four  or  five  years  to  eat  by  himself,  and  not  at  the 
family  table,  unless  the  other  members  of  the  household 
can  themselves  co-operate  with  the  small  boy  or  girl  in 
eating  for  body  strength  and  health.  Usually  the  eve- 
ning dinner  is  later  than  the  child  should  take  his 
evening  meal,  and  it  becomes  a  simple  matter  to  serve 
his  simple  meal  at  5 :  30,  and  his  appetite  is  entirely 
satisfied  when  an  hour  later  his  elders  partake  of  theirs. 

Between  Meals 

Never  should  food  be  allowed  between  meals.  If  the 
hungry  boy  waits  until  mealtime,  he  will  eat  at  the  right 
time  the  food  he  needs,  and  care  much  less  about  the 
sweet  after-part.  Plain  food  will  taste  good  and  be 
quite  satisfactory,  and  the  supply  taken  will  be  suffi- 
cient to  last  until  the  next  regular  meal.  If  the  boy 
after  school  must  have  something  to  "  stay  his  stomach  " 
until  supper  time,  let  it  be  an  apple  or  other  fruit,  and 
this  the  regular  daily  plan,  instead  of  a  spasmodic  one. 

School  Lunches 

For  school  lunches,  fresh  juicy  fruits  should  always 
be  included  if  possible.  In  addition,  a  ripe  banana, 
dates,  raisins,  nuts,  and  olives  are  valuable.  Stuffed 
dates  are  easily  prepared  and  are  enjoyed  quite  as  well 
as  the  less  hygienic  sweets.  These  foods,  together  with 
whole-wheat  or  Graham  sandwiches  made  so  as  to  sup- 
ply protein  and  vitamines,  and,  if  possible,  a  thermos 
bottle  of  milk  or  vegetable  soup,  make  the  best  lunches 
for  growing  boys  and  girls.  (See  page  170.) 


FEEDING   OF    CHILDREN  187 

Amount  of  Food  Needed  by  Child 

During  the  period  of  growth  and  development,  much 
more  food  is  needed  per  pound  of  body  weight  than 
after  maturity  is  reached.  It  is  impossible  to  say  how 
much  food  a  growing  child  may  need.  It  all  depends 
upon  the  activity  of  the  child  and  the  rapidity  with 
which  new  tissues  are  formed.  The  child  who  cares 
little  for  vigorous  play  but  enjoys  his  books,  should  eat 
less  food  than  the  one  who  plays  hard  all  day.  Other 
things  being  equal,  the  child  of  phlegmatic  temperament 
will  need  less  food  than  the  one  who  is  of  a  more  nerv- 
ous, impulsive  type.  The  amount  of  food  needed  depends 
upon  tissue  activity,  and  this  varies  with  individual 
temperament.  Boys,  because  of  greater  muscular  activ- 
ity, need  more  food  than  do  girls. 

Every  mother  should  see  that  her  child  gets  active 
physical  exercise  daily.  Then  if  the  boy  or  girl  is  fed 
regularly,  does  not  eat  between  meals,  eats  wholesome 
food,  prepared  with  due  regard  for  hygienic  principles 
as  outlined  above,  the  appetite  will  be  one  of  the  best 
guides  as  to  the  amount  of  food  required. 

Lack  of  Appetite 

When  the  appetite  of  the  child  seems  to  fail,  it  usu- 
ally means  that  he  has  been  eating  too  much  concen- 
trated food,  and  limiting  his  diet  for  a  meal,  or  a  day, 
to  fruits  and  fruit  juices,  will  often  prove  very  beneficial 
and  insure  a  speedy  return  to  a  good  appetite.  A  care- 
ful estimate  for  a  few  weeks  of  the  calories  taken  by 
the  child  will  be  of  advantage  to  the  mother  from  an 
educational  standpoint,  and  will  permit  her  to  study  and 
to  determine  the  results  when  the  daily  amount  in  food 
units  is  decreased  or  increased  for  a  time. 

Because  of  the  constant  formation  of  new  tissue,  the 
protein  part  of  the  child's  diet  may  well  be  kept  to  at 


188  THE    HOME   DIETITIAN 

least  the  minimum  standard  for  the  adult  —  that  of  200 
calories.  This  is  by  no  means  to  be  regarded  as  an 
arbitrary  standard.  The  point  to  be  emphasized  is  that 
the  child  needs  a  relatively  higher  protein  ration  than 
the  man.  It  should  be  remembered  that  it  is  not  bulk 
so  much  as  concentration  of  food  that  determines  its 
caloric  value.  And  also  that  the  candy  or  knickknack 
taken  between  meals  may  increase  the  total  food  value 
above  actual  body  requirement,  even  though  the  child 
eats  a  comparatively  small  amount  of  food  at  mealtime. 

Body  Demands  Great 

Do  not  underfeed  your  children.  They  must  be  prop- 
erly and  sufficiently  nourished.  Their  body  demands  are 
great  and  must  be  supplied,  but  they  can  have  enough 
food  without  that  which  will  handicap  rather  than  help 
the  body  in  its  work.  Of  protein  they  must  have  an 
ample  amount,  of  carbohydrate  and  fat  a  normal  supply, 
but  they  may  get  this  without  excess  and  with  every 
advantage  to  their  growing  needs.  Great  danger  lies  in 
a  diet  for  them  top-heavy  in  fats  and  carbohydrates, 
with  often  not  enough  protein.  The  results  of  such  an 
unbalanced  diet  are  serious,  and  parents  should  know 
how  to  avoid  a  mistake  which  is  far  too  common.  Some 
sweets  they  should  have,  but  the  intelligent  mother,  hav- 
ing mastered  the  important  principles  of  nutrition,  will 
supply  these  in  a  simple,  not  too  concentrated  form  and 
combined  in  a  healthful  way.  She  will  be  teacher  as 
well  as  mother,  and  will  teach  her  boys  and  girls  that 
the  most  wonderful,  the  most  manly,  womanly  thing 
they  can  do  is  to  develop  strong,  healthy,  normal  body 
machines  that  will  make  of  them  strong,  noble  men  and 
women,  able  always  to  do  well  their  part  and  to  make 
a  success  of  life. 


CHAPTER  XXII 
FADS 

WHAT  to  eat  has  always  been  the  big  and  engrossing 
question  with  mankind  ever  since  Eve  in  the  garden 
made  her  first  great  mistake,  and  Adam  as  the  result 
was  sentenced  to  a  lifelong  earning  of  his  bread  in  the 
sweat  of  his  face.  The  question  has  been  an  absorbing 
one  from  the  viewpoint  of  the  epicurean  whose  desire 
was  to  find  some  new  thing  with  which  to  please  the 
palate,  to  that  of  the  man  or  woman  who  in  the  face  of 
poverty  has  had  the  problem  to  solve  with  the  wolf  at 
the  door. 

What  Shall  We  Eat? 

The  primary  thought  in  regard  to  eating  having  ever 
been  to  please  the  senses,  man  has  long  since  reached 
the  place  where  because  of  certain  discomforts  and  ail- 
ments obviously  due  to  error  somewhere  in  the  amount 
or  kind  of  food  taken,  he  asks  the  question,  "  What  shall 
I  eat?  "  from  the  standpoint  of  one  who  has  come  to 
realize  that  he  must  eat  to  live  rather  than  live  to  eat. 

We  hear  the  question  from  the  man  or  woman  who 
regards  it  sanely,  sensibly,  and  with  a  real  desire  to 
understand  the  principles  underlying  nutrition;  and 
from  the  fanatic  and  the  hypochondriac,  who  look  upon 
all  food  as  an  enemy  and  seem  to  think  that  the  less  of 
it  and  in  the  more  unpalatable  form  the  better,  expect- 
ing that  everything  eaten  will  cause  distress  unless  it 
be  taken  according  to  the  most  rigid  rules  and  with  the 
utmost  self-denial. 

This  question  has  been  carefully  investigated  from  the 
viewpoint  of  science,  more  and  greater  light  has  grad- 

189 


190  THE    HOME   DIETITIAN 

ually  been  thrown  upon  it,  until  today  those  interested 
in  this  all-important  subject  have  only  to  study  the 
proper  literature  to  learn  much  in  regard  to  the  scien- 
tific principles  underlying  the  question  of  how  to  sup- 
ply the  body  with  proper  food. 

Fads  Many  and  Varied 

Together  with  a  fund  of  scientific  facts  accessible  to 
the  investigative  mind  are  various  fancies  and  fads 
brought  forth  by  those  who  in  their  searching  have 
often  got  but  a  single  truth  instead  of  the  whole  fun- 
damental outline  involving  body  nutrition.  Fads  in  re- 
gard to  diet  are  many  and  varied.  The  question  of  eat- 
ing having  become  so  problematical,  men  both  scientific 
and  otherwise  have  advanced  many  theories  as  to  the 
practical  solution  of  these  dietetic  problems. 

Fasting 

The  partaking  of  food  leading  to  so  many  ills,  it  has 
been  only  a  matter  of  course  that  some  one  should  come 
forward  with  the  assertion  that,  if  eating  causes  such 
a  large  proportion  of  sickness,  abstinence  from  food 
would  undoubtedly  prove  a  cure-all,  and  so  the  "  fast- 
ing "  fad  has  had  its  day. 

Forced  Feeding 

So  much  trouble  has  resulted  from  faulty  and  incom- 
plete nutrition,  that  it  has  seemed  the  natural  thing  that 
an  effort  be  made  to  overcome  this  condition  by  forcing 
an  excess  of  food  upon  the  body.  The  thought  has  been 
that  at  least  a  part  of  the  excess  must  be  assimilated 
and  that  the  body,  gaining  strength  from  added  nour- 
ishment, would  be  better  able  to  cope  with  problems  due 
to  a  weak  digestive  tract.  And  so  "  forced  feeding " 
has  played  a  great  part  in  the  treatment  of  anemic 
conditions,  malnutrition,  and  wasting  disease,  as  tuber- 
culosis, etc. 


FADS  191 

Low  Protein 

Abnormal  conditions  resulting  from  errors  in  protein 
digestion  and  metabolism  being  so  apparent,  the  "  low 
protein  "  idea  has  been  advanced,  and  many  have  been 
led  to  the  extreme  of  omitting  as  nearly  as  possible  all 
protein  from  the  diet  —  subsisting  on  a  meatless,  egg- 
less,  milkless  diet,  with  nothing  to  take  the  place  of 
these  protein  foods. 

Milk  Diet 

Protein,  however,  being  such  a  necessity  and  the  harm 
resulting  from  a  deficient  protein  diet  so  apparent,  to 
secure  this  food  in  as  digestible  and  assimilable  a  form 
as  possible  has  seemed  most  important,  and  so  the  "  milk 
diet "  has  had  and  still  holds  a  great  place  as  a  "  cure- 
all  "  for  all  conditions  of  disturbed  nutrition  and  chronic 
disease. 

No  Breakfast 

Others,  seeing  conditions  so  often  resulting  from  an 
overworked  digestive  tract  and  an  excessive  body  fuel 
supply,  have  sought  to  solve  the  problem  and  to  obtain 
results  by  the  "  no  breakfast  plan,"  which  has  worked 
admirably  in  many  cases. 

Raw  Food 

Again,  the  prevalence  of  eating  processed,  overcooked, 
overseasoned  foods  having  been  so  evidently  a  factor  in 
the  causation  of  disease,  the  advantages  of  the  other  ex- 
treme have  been  widely  heralded,  and  the  "  raw  food  " 
fad  has  had  a  great  following,  with  much  benefit,  no 
doubt,  to  some. 

Combinations 

So  much  of  digestive  disturbance  seemingly  being  due 
to  improper  combination  of  various  sorts,  many  have 
thought  that  all  dietetic  errors  might  be  corrected  if 


192  THE   HOME   DIETITIAN 

a  few  rules  in  regard  to  what  foods  may  be  combined, 
were  obeyed,  and  so,  many  "  diet  specialists  "  have  con- 
fined their  dietetic  teaching  to  the  question  of  "  combi- 
nations." So  we  hear  that  a  starch  and  an  acid  must 
not  be  eaten  at  the  same  meal;  bread  must  not  be  eaten 
with  starchy  foods;  two  starches  must  not  be  combined; 
two  kinds  of  fruits,  fruit  and  vegetables,  fruit  and  milk, 
are  all  wrong  combinations,  until  one  finds  himself  so 
surrounded  by  a  maze  of  rules  that  bewilderment  re- 
sults and  fear  lest  some  rule  be  disobeyed  takes  such 
a  hold  that  eating  becomes  a  burden  and  the  digestive 
organs,  affected  by  anxious  mental  impulse,  are  unable 
to  care  for  the  simple  food  that  may  be  taken.  These 
bewildered  friends,  still  suffering  ills  apparently  due  to 
dietetic  mistakes,  are  at  loss  to  know  how  to  solve  a 
problem  which  becomes  more  and  more  a  vital  one,  and 
in  desperation  ask  the  question,  "What  can  we  eat?" 

"  Eat  What  You  Want  " 

Along  with  this  comes  the  theory  that  it  does  not 
make  any  difference  what  you  eat ;  "  forget  it  and  eat 
what  you  want."  Build  up  the  general  health  by  exer- 
cise, and  proper  and  regular  living;  maintain  the  cor- 
rect mental  attitude  and  eat  what  your  appetite  calls 
for.  For  those  who  have  long  been  introspective  and 
have  feared  to  eat,  this  advice  may  be  very  timely. 

Many  Winds  of  Doctrine 

We  should  wish  no  one  to  think  that  we  have  not  the 
fullest  respect  for  each  one  of  these  various  rules  in 
regard  to  eating.  Each  one  has  done  much  good,  and 
in  selected  cases  under  proper  supervision  there  is  no 
doubt  but  that  each  one  of  these  may  apply  and  per- 
haps in  a  more  or  less  modified  way  be  used  with  great 
success  in  the  treatment  of  various  and  sundry  abnor- 


FADS  193 

mal  conditions.  Every  one  of  these  hobbies  has  had  its 
basis  in  truth.  It  is  in  the  applicaticn  that  mistakes 
have  been  made.  The  rule  has  been  advanced,  the  rea- 
son why  has  been  vague  and  indefinite,  and  the  people, 
untaught  in  regard  to  body  processes  and  food  composi- 
tion, have  been  tossed  about  by  many  winds  of  dietetic 
doctrine. 

A  Better  Way 

The  reason  for  these  rules  in  regard  to  eating  becomes 
very  apparent  when  one  has  been  properly  educated  in 
food  fundamentals.  The  application,  based  upon  princi- 
ple, then  becomes  plain  and  the  modern  housewife,  as 
the  home  dietitian,  may  wisely  plan  the  food  program 
for  her  family  in  such  a  way  as  to  apply  sensibly  the 
principles  upon  which  all  these  fads  are  founded.  She 
can  thus  avoid  the  necessity  of  having  members  of  her 
family  submit  to  any  one  of  the  above  lines  of  dietetic 
treatment  for  the  correction  of  conditions  which  are 
brought  on  by  overeating,  undereating,  or  improper 
eating  of  any  sort. 

Briefly,  we  will  consider  the  principles  underlying  the 
application  of  the  eight  methods  given  above  of  over- 
coming nutritional  ills. 

An  Antitoxic  Diet 

1.  Fasting. —  In  conditions  of  auto-intoxication  and 
overloaded  digestive  tract,  excessive  putrefaction  in  the 
large  intestine  and  a  body  often  supersaturated  with 
nourishment,  a  fast  for  a  more  or  less  limited  time 
undoubtedly  would  be  indicated.  It  must  be  remem- 
bered, however,  that  except  perhaps  for  a  short  time, 
the  advantage  of  a  complete  fast,  without  the  disad- 
vantage, may  be  obtained  by  a  modified  fast,  such  as  a 
food  supply  limited  to  those  things  that  will  tend  to 
decrease  auto-intoxication,  e.  g.,  fruits  and  fruit  juices. 

13 


194  THE    HOME   DIETITIAN 

These  may  be  taken  alone  or  with  vegetable  broth  or 
green  vegetables,  and  perhaps  lactic  acid  foods,  as  cot- 
tage cheese,  buttermilk,  and  yogurt.1  An  occasional 
meal  missed,  or  a  day  without  food  or  with  nothing  but 
fruit,  will  often  be  found  a  great  advantage.  "  Abstemi- 
ousness in  diet  is  rewarded  by  mental  and  moral  vigor." 
-  White. 

2.  Forced   Feeding. —  Less   can   be   said   in   favor   of 
this  plan.     However,   there   are   cases   where  the  food 
supply  has  long  been  deficient  when  it  may  be  found  a 
decided  advantage  to  insist  upon  the  ingestion  of  food 
in  amounts  necessary  to  supply  the  excess  of  nourish- 
ment needed   to   build   up   a   body   long   weakened   and 
wasted  from  lack  of  food.     This  is  to  be   done  grad- 
ually and  carefully,  with  due  regard  for  existing  con- 
ditions and  dietetic  principles.    This  plan  should  always 
be  carried  out  under  competent  supervision. 

Serious  Results 

3.  Low  Protein. —  Those  who  have  long  overeaten  of 
protein  food  and  are  suffering  the   results  of   protein 
putrefaction  in  the  intestine  and  incomplete  protein  me- 
tabolism, often  do  well  for  a  time  on  much  less  than  a 
normal  supply  of  this  nitrogenous  food,  until  the  excess 
has  been  eliminated  and  the  body  calls  for  more  to  keep 
up  actual  repair.     However,  this  must  be  done  carefully, 
as   an   exceedingly   low  protein   diet   continued  for  too 
long  a  time  will  result  in  weakness,  lowered  nerve  tone, 
malnutrition,  and  even,   because  of  lowered  resistance, 
in  an  increased  susceptibility  to  such  diseases  as  tuber- 
culosis.    In  these  cases  the  ingestion  of  protein  is  less 
than  the  outgo;  the  body  is  out  of  nitrogenous  equilib- 


1  In  the  dietetic  treatment  of  diabetes,  an  initial  period  of  fasting  is  often  car- 
ried on  under  the  careful  supervision  of   the  attending  physician.      (See  page  249.) 


FADS  195 

rium    (see  footnote,   page  38),  and  the  results  will  be 
serious  unless  the  condition  is  soon  corrected. 

In  Selected  Cases 

4.  The   Milk  Diet. —  This    diet   is   valuable   in   many 
cases.    It  permits  of  an  excess  of  nourishment  in  an  eas- 
ily digested  and  assimilated  form.     Many  will  take  the 
amount  of  food  units  that  their  body  needs  and  the 
excess  that,  because  of  depleted  conditions,  they  should 
have  for  a  time,  in  the  form  of  milk  better  than  in  any 
other  way.    However,  we  believe  that  these  cases  should 
be  carefully  selected  and  that  often  the  same,  or  even 
better,  results  may  be  obtained  by  a  modified  milk  diet, 
or  by  a  diet  in  which  the  same  advantages  may  be  de- 
rived without  the  absolute  restriction.     We  know  of  no 
serious  objection  to  the  milk  diet  as  a  trial,  even  though 
the  same   results   might   be   obtained   in   another   way. 
The  plan  is  simple  and  needs  not  the  thorough  knowl- 
edge of  foods  necessary  in  planning  a  varied  diet  with 
the  same  results  in  view. 

Often  little  permanent  good  results  from  this  plan 
of  feeding,  because  the  patient,  upon  going  back  to  his 
usual  dietetic  program,  returns  to  the  same  errors  that 
led  to  trouble  in  the  first  place;  so  he  has  gained  little 
in  the  way  of  lasting  benefit  if  in  addition  to  the  milk 
diet  he  has  not  obtained  a  knowledge  of  the  normal 
rational  eating  that  makes  for  health. 

5.  The  No-Breakfast  Plan. —  This  plan  we  consider  a 
very  good  one  because,  first,  many  have  eaten  a  hearty 
dinner  the  evening  before,  their  digestive  organs  have 
had  to  work  while  they  slept  and  are  in  no  condition 
in  the  early  morning  to  take  up  the  work  of  digesting 
even   a  light  breakfast;  secondly,  the  plan  lessens  the 
daily  food  intake  and  discourages  overeating;  thirdly, 
the   digestive   organs    should    have   more    rest   between 


196  THE    HOME    DIETITIAN 

meals  than  they  usually  get,  six  to  eight  hours  inter- 
vening being  the  ideal.  With  no  breakfast  and  an  early 
lunch  this  would  be  accomplished. 

It  can  readily  be  seen,  however,  that  understanding 
the  principle,  one  may  get  the  same  advantageous  re- 
sults by  leaving  out  supper  or  by  eating  carefully  three 
times  a  day. 

6.  Raw    Food    Diet. —  The    advantages    of    this    are 
many: 

a.  It  insures  an  ample  supply  of  vitamines,  which  less- 
ens the  amount  of  protein  needed.      (See  Chapter  IX.) 

b.  It  necessitates  thorough  mastication. 

c.  It  prevents  rapid  eating. 

d.  It  hinders  excessive  seasoning  and  the  use  of  super- 
heated fats. 

e.  Many    vegetables    are    more    digestible    raw    than 
cooked. 

These  principles  borne  in  mind  will  enable  one  to 
avail  himself  of  all  the  advantages  of  the  raw  food  diet 
without  the  restrictions.  However,  too  much  cannot  be 
said  in  favor  of  the  eating  of  vegetables  and  fruits  raw, 
a  certain  amount  of  these  taken  daily  being  a  decided 
advantage. 

7.  Combinations. —  This  is  by  no  means  an  unimpor- 
tant subject,  and  the  housewife  wishing  to  feed  her  fam- 
ily for  the  best  results  in  health  and  vigor,  should  be 
informed  as  to  the  principles  underlying  this  phase  of 
dietetics.     But  here,  as  elsewhere,  those  who  have  only 
a  few  rules  by  which  to  be  guided,  without  a  knowledge 
of  the  reasons  why,  will  often  fail  to  accomplish   the 
important  results  they  seek.      (See  Chapter  XX.) 

8.  "  Eat   What  You  Want."    -  For  the  poor  neuras- 
thenic,  who   has   forgotten   everything   in   life   but  the 
question  of  what  he  dare  put  into  his  stomach,  this  is 


FADS  197 

perhaps  the  best  of  all.  And  it  explains  the  often  ap- 
parently marvelous  results  of  various  faith  cures,  so 
called.  Too  much  attention  to  the  digestive  tract  may 
be  worse  than  none  at  all,  and  some  may  well,  for  a 
time  at  least,  "  forget  it." 

Principles,  Not  Rules 

Again  the  importance  of  intelligent  application  of 
principle  cannot  be  too  emphatically  urged.  Let  us 
know  our  bodies  and  their  needs;  supply  them  wisely 
and  in  a  masterly  way,  and  thus  rise  above  the  petty 
handicaps  that  hinder  us  in  our  endeavor  to  reach  our 
ideals  and  to  find  success. 


"  There  ate  mo)e  thinyx  in  heaven  and  earth, 
Horatio,  than  are  dreamt  of  in  your  philoso- 
phy."—  Shakespeare. 


CHAPTER  XXIII 
FOOD  ECONOMY 

INTELLIGENT  economy  in  food  means  conservation,  not 
only  of  food  but  also  of  health.  This  was  well  illus- 
trated in  the  food  conservation  campaign  during  the 
Great  War.  Up  to  that  time  the  American  people,  as 
a  whole,  had  known  little  real  need  for  economy  in  any 
direction,  and  the  resulting  profligacy  in  foods  went 
hand  in  hand  with  extravagant  expenditures  of  body 
resources  as  regarded  health. 

The  season  of  stress  through  which  we  so  recently 
passed,  demanding  the  greatest  effort  in  the  direction  of 
food  economy,  could  only  result  in  a  betterment  of  the 
general  health  of  the  people,  for  it  placed  a  very  definite 
check  on  overeating,  which,  of  all  wastes,  should  be 
studiously  avoided,  because  it  wastes  not  only  food  but 
health.  Better  to  let  perfectly  good  food  rot  in  the 
garbage  can  than  in  the  digestive  tract,  much  as  the 
former  is  to  be  deplored. 

In  the  light  of  scientific  education  the  knowledge  im- 
parted to  the  people  at  that  time  was  of  inestimable 
value.  Many  a  mother  was  blessed  with  a  new  vision. 
The  needs  of  the  hour  gradually  lent  a  new  interest  to 
her  plans.  Her  work  was  no  longer  a  mere  drudgery, 
with  its  only  purpose  to  please  the  varied  tastes  of  a 
family  demanding  that  their  appetites  be  pampered  three 
times  a  day,  but  she  became  master  of  a  new  situation, 
that  of  furnishing  the  table  with  foods  adequate  for 
body  needs,  yet  balanced  with  such  correctness  that 
there  was  the  least  possible  waste  in  the  raw  material, 
in  its  preparation,  or  in  its  ultimate  utilization  by  the 
body.  This,  while  meeting  the  situation  of  the  hour, 

193 


FOOD  ECONOMY  199 

she  learned,  promised  the  highest  and  most  satisfactory 
results  in  the  health  and  strength  of  those  eating  at  her 
table.  She  found  herself  no  longer  merely  a  cook,  but 
a  dietitian  as  well,  whether  she  prepared  the  food  with 
her  own  hands  or  directed  its  preparation.  Thus,  while 
she  served  her  country,  she  became  an  added  blessing 
to  her  family  and  to  the  race. 

The  need  no  longer  so  urgent,  many  a  housewife, 
having  learned  the  way  of  true  economy,  still  continues 
to  guide  the  eating  habits  of  her  family  in  the  direction 
that  will  lead  to  the  results  most  needed  by  the  home 
and  nation  in  time  of  peace  as  well  as  in  time  of  war. 
But  there  are  others,  and  more,  who  are  too  prone  to 
forget  the  lessons  of  that  time  and  to  drift  back  into 
habits  of  eating  that  because  of  the  very  abundance  of 
the  food  supply,  can  only  tend  to  lower  the  standard 
of  health. 

True  food  economy  in  so  far  as  the  body  is  concerned, 
is  the  partaking  of  the  minimum  amount  of  food  neces- 
sary to  fully  supply  the  body  needs  and  to  keep  one  in 
health  with  some  reserve  in  the  form  of  food  stored  as 
fat.  Overeating,  as. we  have  learned,  clogs  the  digestive 
tract,  interferes  with  proper  oxidation  and  with  com- 
plete elimination.  On  this  point  we  can  do  no  better 
than  to  give  the  following,  taken  from  "  Dieto therapy," 
Fitch,  Volume  II,  page  135: 

"  Overeating  causes  congestion  of  the  liver  and  a  con- 
dition known  as  '  biliousness/  in  which  the  stomach 
and  intestines  are  engorged.  Constipation  ensues,  the 
tongue  becomes  heavily  coated,  the  bodily  secretions  are 
altered  in  composition,  and  the  urine  especially  becomes 
overloaded  with  salts.  It  is  evident  that  we  are  not 
nourished  by  the  food  we  eat,  but  by  the  amount  we 
can  properly  use  and  assimilate.  Probably  an  excess 
beyond  this  amount  is  beneficial,  because  it  supplies  a 


200  THE    HOME    DIETITIAN 

reserve  upon  which  the  body  can  depend  for  nourish- 
ment in  time  of  need.  However,  it  is  absolutely  patent 
that  chronic  overeating  so  clogs  the  machinery  of  the 
body  that  the  organs  of  elimination  and  excretion  are 
unable  to  work  as  they  should,  intestinal  stasis  follows, 
the  surplus  food  material  putrefies  before  it  is  absorbed 
in  the  intestine,  the  urinary  tract  becomes  infected,  the 
circulation  becomes  involved  in  the  toxic  invasion,  and 
the  whole  system  is  poisoned. 

"  This  condition  of  intestinal  toxemia  brings  in  its 
train  many  mental  and  physical  disabilities.  The  nerv- 
ous and  muscular  systems  become  saturated  with  .the 
end  products  of  protein  digestion,  producing  a  state  of 
lassitude,  headache,  fatigue,  drowsiness,  and  even  men- 
tal stupor. 

"  The  effect  of  chronic  overeating  on  the  mental  pow- 
ers is  very  evident.  Indeed,  it  may  be  laid  down  as  an 
axiom  that  a  person  who  habitually  overeats  is  incapable 
of  good  or  sustained  mental  work.  .  .  .  The  brain  worker 
or  business  man,  who  eats  largely,  especially  in  the 
middle  of  the  day,  cannot  use  his  mental  powers  prop- 
erly. His  mind  loses  its  acuity;  and  as  for  flights  of 
imagination,  if  he  is  a  literary  man,  they  are  impossible. 
Overeating  is  an  insurmountable  obstacle  in  the  way  of 
mental  endeavor.  The  handicap  placed  upon  the  entire 
system  as  the  result  of  overeating  is  too  great  to  be 
overcome,  and  the  mind  refuses  to  respond  to  the 
stimulus  of  thought." 

And  again,  from  an  editorial  in  the  Medical  Record, 
June  16,  1917 :  "  Economy  in  food  does  not  signify  ill 
health,  but  rather  the  reverse,  as  undoubtedly  in  time 
of  peace  and  prosperity  a  very  large  number  of  people 
eat  unsuitable  food  and  more  than  is  good  for  them." 

The  big  food  problem  of  the  war  was  that  of  having 
enough  food  to  go  around.  The  solution  to  this  lay 


FOOD   ECONOMY  201 

largely  in  every  one's  eating  only  enough  to  adequately 
supply  his  physical  needs,  but  this  necessitated  the  edu- 
cation of  the  people  and  obtained  for  them  information 
as  to  food  values  and  body  nutrition  that  they  had  al- 
ways needed  but  had  never  received.  Dr.  H.  Edwin 
Lewis  said  in  American  Medicine  of  May,  1917:  "Not 
tie  least  of  the  duties  of  this  department  [Department 
of  Food  Conservation]  will  be  the  systematic  dissemi- 
nation of  information  in  regard  to  the  amounts  and 
kinds  of  foods  required  to  maintain  perfect  health." 

But  not  only  was  a  reduction  in  the  total  amount  found 
necessary,  but  certain  kinds  of  foods  needed  to  be  used 
more  sparingly  and  with  greater  care,  and  we  saw  the 
civilized  world  thrust  back,  as  it  were,  by  the  irresist- 
ible force  of  circumstances,  to  the  normal  food  balance, 
proportionate  with  natural  supply.  Invariably,  the 
foods,  in  the  use  of  which  there  had  to  be  a  reduction, 
were  those  foods  that  we  had  been  using  in  excess  of 
physical  need  and  that  we  could  not  have  had,  had  not 
the  total  food  supply  been  so  abundant.  And  we  found 
that  many  things  ordinarily  considered  only  waste,  con- 
tained valuable  food  elements  which  were  in  many  cases 
sorely  needed  to  balance  up  a  one-sided  food  intake.  So 
the  outcome  of  this  most  valuable  educational  campaign, 
in  so  far  as  suggestions  were  carried  out,  could  only 
mean  a  normal  readjustment  of  food  supply  with  a 
proper  balance  as  to  food  intake.  The  suggestions  of 
the  Department  of  Food  Conservation  read  like  an  out- 
line in  hygienic  dietetics,  and  we  could  perhaps  find  no 
better  summary  for  healthful  eating  than  is  found  in 
the  following: 

First,  eat  less  meat.  We  came  face  to  face  with  the 
fact  of  our  extravagance  in  feeding  so  much  of  our  food 
grains  to  stock -and  then  killing  and  eating  the  animals 
which  might  have  been  saved  for  the  production  of 


202  THE    HOME   DIETITIAN 

milk,  by  far  the  most  economic  method  of  converting 
vegetable  to  animal  food.  We  were  reminded  that  every 
pound  of  meat  not  eaten  would  save  ten  pounds  of  grain, 
and  the  economic  value  of  a  vegetarian  diet  became 
very  apparent.  (See  Chapter  XV.) 

Second,  eat  less  fat.  In  "  Ten  Lessons  of  Food  Con- 
servation," by  the  United  States  Food  Administration, 
we  were  advised  to  "  avoid  cooking  by  means  of  frying/' 
and  again,  to  "  preach  the  gospel  of  reducing  the  total 
amount  of  fats  one  third  of  an  ounce  per  day  for  each 
adult."  We  were  told  that  the  waste  of  one  fourth  of 
an  ounce  of  butter  daily  in  every  one  of  our  twenty 
million  households  would  mean  312,500  pounds  a  day, 
114,062,500  pounds  a  year.  Among  other  suggestions 
there  were  these :  "  Choose  recipes  calling  for  less  fats ;  " 
"  use  cream  desserts  sparingly ;  "  "  buy  whole  milk  in- 
stead of  cream;  use  the  top  milk  on  cereals,  etc.,  and 
the  remainder  for  drinking  and  cooking."  (See  Chap- 
ter VII.) 

Third,  reduce  our  sugar  supply.  It  was  suggested 
that  more  honey  be  used;  that  fresh  fruits  be  eaten 
more  plentifully  instead  of  the  cooked  foods  requiring 
sugar;  that  dried  fruits  be  used  to  take  the  place  of 
sugar;  that  dried  fruits  be  added  to  desserts,  in  this 
way  lessening  the  amount  of  sugar  needed.  (See  Chap- 
ter VIII.) 

Fourth,  do  without  ivhite  flour.  We  found  it  neces- 
sary to  use  flours  made  from  a  variety  of  cereals,  as  oat- 
meal, cornmeal,  buckwheat,  and  rice.  Those  most  ad- 
dicted to  the  use  of  fine  flour  bread  learned,  because  of 
war-time  necessity,  to  cultivate  a  taste  for  breads  made 
from  the  coarse,  unrefined,  whole  grains.  (See  Chap- 
ter XIII.) 

Fifth,  use  more  vegetables  in  season  and  prepare 
them  without  waste.  We  were  shown  that  much  that 


FOOD   ECONOMY  203 

was  valuable  in  the  way  of  nutritional  elements  has 
been  thrown  away.  These  parts  the  people  were  urged 
to  use.  (See  Chapter  XII.) 

Sixth,  conserve  fuel.  We  were  urged  to  use  more 
food  in  its  raw  state,  and  whenever  possible  to  use  the 
fireless  cooker.  (See  Chapter  IX.) 

While  the  seventh  and  last  has  perhaps  more  to  do 
with  the  character  than  health,  we  cannot  complete  our 
chapter  without  it. 

Seventh,  waste  not,  want  not.  Our  attention  was 
called  to  the  enormous  waste  in  this  country.  A  govern- 
ment bulletin  told  us  that  the  estimated  food  waste  of 
the  United  States  equaled  in  value  $700,000,000  annually. 
Dr.  H.  Edwin  Lewis,  in  American  Medicine  of  May, 
1917,  said :  "  It  is  a  well-established  fact  that  the  waste 
of  food  each  year  is  enormous.  The  amazing  prosper- 
ity throughout  the  country  during  the  past  few  years 
has  made  the  people  careless,  and  in  the  kitchens  of  our 
homes,  our  large  hotels,  and  public  institutions  especially, 
the  waste,  according  to  very  conservative  estimates  has 
been  said  to  exceed  10  per  cent.  Indeed,  there  are  those 
who,  as  a  result  of  careful  thought  and  investigation,  do 
not  hesitate  to  say  that  20  per  cent  is  nearer  correct. 
.  .  .  There  is  the  waste  due  to  thoughtless  extravagance 
in  supplying  our  tables,  a  common  fault  of  which  the 
majority  of  the  American  people  are  guilty.  Thus,  at 
every  meal  in  the  home  or  public  eating  place  the  aver- 
age individual  invariably  insists  on  having  a  great  deal 
more  than  he  needs  —  often  more  than  he  can  possibly 
eat.  The  remainder  is  usually  thrown  away." 

From  the  Independent  at  that  time  the  following  was 
taken :  "  What  is  needed  is  the  individual  cultivation  of 
the  custom  of  taking  no  more  food  on  the  plate  than 
one  expects  to  eat  and  then  eating  it  all,  unless  it  proves 
unpalatable  or  excessive.  If  this  practice  were  univer- 


204  THE    HOME    DIETITIAN 

sal,  we  should  have  enough  to  put  up  a  palatial  post 
office  in  every  hamlet,  pension  the  descendants  of  all  the 
soldiers,  build  the  biggest  navy  in  the  world,  and  carry 
out  many  of  the  schemes  of  social  improvement  urged 
upon  us." 

The  lessons  learned  at  that  time  were  productive  of 
much  good.  Many  are  still  profiting  by  them,  but  with 
others  there  is  the  tendency  to  drift  back  to  the  old 
careless  habits.  Perhaps  the  high  cost  of  living  is  not 
without  its  advantages,  in  that  it  enforces  economy  as 
regards  those  foods,  the  extravagant  use  of  which  can 
only  be  detrimental  to  health. 

Even  in  times  of  prosperity  the  world's  needs  are 
great  enough  to  demand  conservation  of  resources  in 
every  way  possible.  "  The  gospel  of  the  clean  plate,"  so 
impressed  upon  our  minds  in  times  of  stress,  should 
never  be  forgotten  in  times  of  prosperity,  and  the  ad- 
monition to  "  gather  up  the  fragments  that  remain,  that 
nothing  be  lost,"  should  be  the  rule  of  daily  living,  no 
matter  how  abundant  our  supply.  From  every  view- 
point the  problem  of  feeding  the  family  with  the  least 
expense,  the  least  food  waste,  and  the  best  results  in 
a  sufficient  and  properly  balanced  food  supply,  may  be- 
come one  of  fascinating  interest.  It  may  make  of  the 
housewife  a  scientist  as  well  as  an  artist.  It  may  help  to 
raise  home-keeping  to  the  dignity  of  a  profession,  and  in 
the  time  of  greatest  prosperity  do  more  for  the  nation  in 
the  conservation  of  resources  and  of  race  betterment 
than  can  in  any  other  way  be  accomplished. 

"  Much  food  is  in  the  tillage  of  the  poor:  but 
there  is  that  is  destroyed  for  want  of  judg- 
ment."—  Bible. 


CHAPTER  XXIV 

A  VEGETARIAN   DIET  WITHOUT   DAIRY 
PRODUCTS 

Lacto- Vegetarianism 

VEGETARIANISM,  as  generally  applied,  means  a  diet 
free  from  flesh  food.  However,  strictly  speaking,  it  re- 
fers to  a  diet  derived  entirely  from  vegetable  sources, 
all  animal  food,  such  as  milk,  eggs,  and  butter  being 
excluded.  A  fleshless  diet,  including  milk,  has  been 
more  exactly  termed  lacto-vegetarianism,  and  this,  Mc- 
Collum  says,  has  been  found  to  be  "  the  most  highly 
satisfactory  diet  ever  adopted  in  the  nutrition  of  man," 
and  is  what  is  usually  meant  by  the  term  "  vegetarian- 
ism." Careful  investigation  shows  that  it  is  possible  also 
to  derive  all  necessary  food  elements  and  a  properly 
balanced  ration  from  a  strictly  vegetarian  diet.  But, 
to  accomplish  this  requires  so  detailed  a  knowledge  of 
foods  and  their  values,  with  such  a  degree  of  wisdom 
in  their  combination,  that  the  general  adoption  of  such 
a  diet  would  be  fraught  with  much  danger  to  the  people. 
As  long  as  milk  is  included  in  the  diet,  a  sufficient  and 
balanced  ration  is  easily  possible.  It  is  in  the  elimina- 
tion of  milk  that  the  difficulty  lies. 

Educate  the  People 

Great  strides  would  need  to  be  taken  in  the  education 
of  the  people  before  such  a  dietetic  regime  could  safely 
be  advised.  And  yet,  as  has  been  demonstrated  in  the 
late  war,  there  are  times  in  the  experience  of  man  when 
a  knowledge  that  would  make  it  possible  for  him  to 
adapt  himself  to  such  a  diet,  would  be  of  infinite  value 

205 


206  THE    HOME   DIETITIAN 

as  a  means  of  life  saving  in  times  of  emergency.1  At 
any  rate,  the  time  is  ripe  for  people  everywhere  to  be 
thoroughly  educated  as  to  the  ways  and  means  of  pre- 
serving proper  nourishment  under  all  circumstances  and 
conditions,  that  they  may  be  resourceful  in  times  of 
unusual  food  conditions,  whether  individual  or  national. 

There  are  individuals  who,  while  needing  the  com- 
plete protein  nourishment  furnished  by  milk  and  eggs, 
are  not  able  properly  to  digest  and  utilize  them.  There 
are  conditions  of  ill  health  which  could  be  markedly 
improved  were  it  possible  for  the  patient  to  be  properly 
nourished  without  the  use  of  animal  protein,  with  its 
tendency  to  intestinal  putrefaction  and  toxemia.  For 
these  a  balanced  ration,  complete  in  every  way,  easy  of 
digestion  and  assimilation,  entirely  of  vegetable  origin, 
would  be  of  great  value. 

For  the  sake  of  these,  and  from  the  standpoint  of  its 
general  educational  value,  we  will  endeavor  to  show  how 


1  Milk. —  The  question  of  milk  is  a  very  obtrusive  one  in  war  time.  It  has  be- 
come almost  an  article  of  faith  that  a  large  supply  of  milk  is  indispensable  to  the 
maintenance  of  good  health,  and  that,  if  a  milk  supply  failed  wholly  or  in  part, 
the  consequences  would  be  disastrous.  In  time  of  war,  foodstuffs  and  feeding  ma- 
terials must  be  economized.  To  find  feeding  material  sufficient  to  maintain  cows 
in  such  a  condition  that  they  will  provide  a  good  supply  of  milk,  implies  a  great 
deal  of  labor  and  also  the  importation  of  an  amount  of  feeding  material  which  is 
inconvenient  when  not  impossible  under  war  conditions.  It  is  assuredly  true  that 
to  conserve  infant  life,  a  certain  supply  of  cow's  milk  is  necessary,  that  is,  in  the 
existing  state  of  affairs,  when  so  many  women  do  not  suckle  their  offspring.  But 
that,  after  the  baby  age  is  passed,  milk  is  an  absolutely  essential  article  of  diet, 
is  strongly  combated  by  many  authorities.  Campbell  went  so  far  as  to  declare  that 
the  child,  as  distinguished  from  the  babe,  does  not  need  milk  and  would  not  suffer 
greatly  if  the  supply  of  dairy  milk  suddenly  failed.  He  argued,  in  the  first  place, 
that  milk,  affording  as  it  does  a  peculiarly  favorable  soil  for  the  growth  of  disease 
germs,  has  carried  disease  and  death  to  hecatombs  of  children.  It  has  further  acted 
injuriously  by  favoring  the  consumption  of  soft,  pappy  foods.  It  is  obvious  that 
the  infant,  like  the  young  of  other  mammals,  requires  milk  for  the  first  period  of 
its  life,  and  that  the  proper  milk  for  it  is  that  of  its  own  mother.  When  this 
source  of  supply  fails  or  is  not  available,  as  so  frequently  occurs  in  these  days, 
resort  must  be  had  to  the  milk  of  other  animals,  cows  or  goats.  This  has  not 
proved  an  unmixed  blessing.  .  .  . 

According  to  Campbell,  while  the  infant  needs  milk  of  some  kind  during  the 
first  nine  or  ten  months  of  life,  it  does  not  need  any  after  that  period.  Why  should 
the  young  of  man  any  more  than  the  young  of  other  mammals,  require  milk  after 
it  has  left  the  breast?  It  is  only  since  man  first  domesticated  the  cow  and  goat 
.  .  .  that  he  has  been  supplied  with  any  milk  other  than  human,  and  it  is  ab- 
surd to  suppose  that  before  that  time  his  health  suffered  from  the  lack  of  cow's 
or  goat's  milk.  The  preagricultural  tribes  to  this  day  are  without  any,  and  until 
civilized  man  deteriorated  them  by  the  introduction  of  alcohol  and  European  vices, 
they  were  magnificent  physical  specimens  of  manhood. —  "  Dietotherapy,"  Fitch, 
Vol.  II,  p.  764. 


VEGETARIAN  DIET  WITHOUT  DAIRY  PRODUCTS        207 

a  strictly  vegetarian  diet  may  be  brought  up  to  the 
standard  of  a  diet  that  is  complete  in  all  food  essentials 
and  capable  of  properly  nourishing  the  body.  We  do 
not  wish  to  be  taken  as  recommending  it  for  general  use. 
The  value  of  milk  and  eggs,  which  would  with  the 
greatest  difficulty  be  substituted,  lies  in  the  complete 
proteins  contained.  It  has  been  made  very  evident  that, 
with  the  proper  use  of  fruits  and  vegetables,  all  essen- 
tial vitamines  and  salts  can  be  freely  supplied.  But  in 
milk  are  found  not  only  vitamines  and  salts,  but  also  a 
high  content  of  complete  protein,  thus  making  in  milk 
a  so-called  "  protective  food."  The  difficulty  in  plan- 
ning a  diet  without  milk  is  in  substituting  its  valuable 
protein.  However,  it  seems  that,  with  necessary  knowl- 
edge and  care,  it  is  possible  for  it  to  be  done. 

Vegetable  Proteins 

Available  proteins  in  the  vegetable  world  are  those 
of  cereals,  legumes,  nuts,  and  leafy  vegetables.  Refer- 
ring to  Chapter  VI,  pages  41-43,  62,  we  understand  that 
cereal  proteins  are  not  complete,  though  some  are  more 
nearly  so  than  others,  and  that  the  deficiency  of  one 
may  be  supplemented  by  the  proteins  of  another.  It  is 
quite  evident,  therefore,  that  variation  rather  than  mo- 
notony, is  to  be  recommended  in  the  dietetic  use  of 
cereal. 

It  has  been  shown  (page  44)  that,  dietetically  speak- 
ing, the  seeds  of  plants,  which  include  the  cereals  and 
legumes,  are  lacking  in  certain  food  elements ;  that  while 
they  are  valuable  sources  of  caloric  food  value,  their 
supply  of  vitamines  and  mineral  salts  and  complete  pro- 
teins is  too  small  to  make  it  possible  to  depend  upon 
them  as  the  sole  source  of  these  essential  elements. 
When  the  aleurone  layer  of  whole-grain  cereals  is  used, 
the  proportion  of  vital  food  elements  is  greater. 


208  THE    HOME    DIETITIAN 

We  have  seen,  too,  that  the  shortcomings  of  the  seeds 
are  supplemented  by  the  dietetic  value  of  the  leaves, 
the  leaves  being  rich  in  the  very  things  in  which  the 
seeds  are  lacking.  This  makes  quite  obvious  the  value 
of  utilizing  both  the  leaf  and  the  seed  in  various  com- 
binations. 

How   to  Combine  Plant  Foods 

The  secret,  then,  of  successfully  utilizing  plants  in  the 
making  up  of  a  complete  diet  is:  First,  to  avoid  mo- 
notony in  the  use  of  cereal,  and  to  so  vary  and  combine 
cereals  that  the  proteins  of  one  may  supplement  the  pro- 
teins of  the  other,  and  to  use  the  whole  grain  instead 
of  the  refined  product ;  second,  to  use,  together  with  the 
"  storage  portion "  of  the  vegetable  (the  root,  tuber, 
and  seed),  a  large  amount  of  the  "  active  respiring  por- 
tion "  (the  leaf  and  the  skin;  see  Chapter  XII);  and 
third,  to  re-enforce  the  vitamines,  salts,  and  proteins  of 
the  vegetables,  legumes,  and  grains  with  a  free  use  of 
fruits  and  nuts. 

Nut  Protein 

As  to  the  value  of  nut  protein,  we  quote  the  following : 
"  Peanuts  are  unusual  in  containing  a  considerable  pro- 
portion of  protein  along  with  both  fat  and  carbohydrate. 
Water-soluble  vitamine  is  also  not  lacking.  Experts  in 
the  office  of  Home  Economics  at  the  United  States  De- 
partment of  Agriculture  have  shown  that  the  nutrients 
of  peanuts  are  easily  digested  by  man.  Johns  and  Finks, 
of  the  same  department,  have  given  an  added  worth  to 
the  food  by  demonstrating  convincingly  the  high  physio- 
logic value  of  the  peanut  protein.  .  .  .  Bread  made  with 
a  mixture  of  25  parts  of  peanut  flour  and  75  parts  of 
wheat  flour  furnished  adequate  proteins  for  normal 
growth  of  experimental  animals."- -Journal  A.  M.  A., 
Aug.  28,  1920. 


VEGETARIAN  DIET  WITHOUT  DAIRY  PRODUCTS    209 

And  again :  "  The  food  chemist  .  .  .  has  long  given  to 
the  various  nuts  a  prominent  place  among  concentrated 
foods.  From  his  analytic  standpoint,  they  may  even  sur- 
pass such  recognizedly  valuable  foods  as  meats,  eggs, 
and  cereals  in  their  concentration  of  nutrients.  .  .  . 

"  Experiments  that  were  conducted  by  Cajori  at  Yale 
emphasized  anew  what  has  long  been  contended  by  Jaffa, 
of  California,  namely,  that  nuts  are  valuable  foods 
judged  by  their  behavior  in  digestion  and  metabolism. 
They  point  out  that  if  nuts  are  eaten  properly  and  used 
in  the  diet  as  eggs,  meat,  and  other  foods  rich  in  pro- 
tein are  eaten,  they  behave  quite  as  well  in  the  body  as 
do  the  ordinary  staple  articles  of  food.  .  .  . 

"  Their  protein  is,  in  general,  of  a  superior  quality. 
.  .  .  In  experiments  just  conducted  at  Yale  University, 
Cajori  has  secured  very  satisfactory  growth  over  long 
periods  in  animals  on  diets  in  which  the  almond,  Eng- 
lish walnut,  filbert,  and  pine  nut,  respectively,  furnished 
the  essential  source  of  protein  in  the  ration.  These  pro- 
teins afford  the  necessary  nitrogenous  complexes  for  the 
elaboration  of  milk  in  the  same  species.  From  a  study 
of  the  relations  of  diet  to  milk  production  in  women, 
Hoobler  pointed  out,  not  long  ago,  that  as  a  rule  ani- 
mal proteins  are  more  efficient  than  vegetable  proteins 
for  the  elaboration  of  human  milk.  However,  nut  pro- 
teins were  an  exception  to  this  generalization,  in  that 
diets  containing  almonds,  English  walnuts,  pecans,  and 
peanut  butter  as  a  source  of  protein,  proved  to  be  as 
suitable  for  milk  production  as  diets  that  furnished  pro- 
tein from  animal  sources.  .  .  . 

Supplementary    Foods 

"  These  observations  indicate  that  nuts  are  sources  of 
abundant  quantities  of  water-soluble  B  vitamine.  .  .  . 
Furthermore,  the  nuts  are  logical  dietary  supplements 
to  many  foods  like  cereals,  roots,  tubers,  and  fruits. 

14 


210  THE    HOME   DIETITIAN 

There's  a  reason,  as  we  now  have  learned." — Journal 
A.  M.  A.,  Oct.  30,  1920. 

"  The  protein  of  almond  meal  was  noted  to  have  a 
'  biologic  value '   superior  to   that  of  wheat  gluten."- 
Journal  A.  M.  A.,  March  8,  1919. 

There  is  much  work  still  to  be  done  along  these  lines, 
but  we  can  begin  to  see  great  possibilities  in  intelligent 
vegetable  food  combination. 

So  now  our  food  quartet  (see  page  220)  is,  fruits, 
vegetables,  cereals,  nuts,  the  nuts  helping  to  take  the 
place  of  the  protein  and  fat  of  milk.  However,  we  must 
not  depend  upon  them  to  entirely  take  the  place  of  the 
vitamines  and  the  mineral  content  of  milk.  The  leafy 
vegetables  also  are  needed  to  supplement  the  dietary 
shortcomings  of  the  legumes,  so  we  see  our  dependence 
upon  the  leaves  of  vegetables  in  our  meatless,  milkless 
diet. 

Maintain  Protein  Standard 

The  principle  is  this:  We  must  depend  upon  whole 
cereals,  legumes,  and  nuts  for  quantity  of  protein,  and 
upon  leafy  vegetables  and  vegetable  extracts  to  supple- 
ment the  other  protein  as  to  quality.  This  is  not  at 
all  discouraging  when  we  read  of  the  quality  of  nut 
protein.  We  should  still  bear  in  mind  the  necessity 
for  at  least  200  calories  of  protein.  If  this  mini- 
mum is  adhered  to,  with  a  free  amount  of  vitamines 
and  mineral  salts,  there  need  be  little  danger  of  insuffi- 
ciency in  the  total  food  supply.  As  protein,  in  nature, 
is  ever  combined  with  fat  and  carbohydrate,  it  becomes 
impossible  to  take  200  calories  of  protein  without  a 
goodly  portion  of  energy  food;  for  example,  15  calories 
of  almond  protein,  if  eaten  in  the  almonds,  carries  with 
it  85  calories  of  almond  fat,  a  concentrated  nutriment. 
Twenty-five  calories  of  legume  protein  means  an  accom- 
panying 75  calories  of  carbohydrates.  Added  carbohy- 


VEGETARIAN  DIET  WITHOUT  DAIRY  PRODUCTS        211 

drate  food  may  ever  be  found  in  cereals,  in  fruits  fresh, 
stewed,  or  dried,  and  additional  concentrated  fat  in  olives. 

Vegetable  proteins  never  being  supplied  in  a  concen- 
trated form,  the  strict  vegetarian,  more  than  all  others, 
must  eat  the  very  least  amount  of  any  artificial  concen- 
trated energy  food,  as  free  fats,  cane  sugar,  etc.,  for  he 
has  not  the  concentration  of  animal  protein  to  maintain 
his  balance  of  nitrogenous  foods. 

So  to  summarize: 

1.  Legumes,  cereals,  nuts,  to  make  up  necessary  pro- 
tein calories. 

2.  Leafy  vegetables  to  supplement  the  above  proteins, 
many  of  which  otherwise  would  be  incomplete. 

3.  Fruits  and  leafy  vegetables  to  supply  vitamines. 

4.  Fruits   and   leafy   vegetables,    with   outer   part   of 
cereals,  to  furnish  mineral  salts. 

5.  Cereals,  legumes,  nuts,  fruits,  and  olives  to  supply 
necessary  added  calories. 

6.  Energy  food  in  unnatural  concentration  used  with 
caution. 

Suggestive  daily  menus  are  given  as  follows: 

Sample  Breakfasts 

Protein  Total 

No.   1  Calories  Calories 

Fruit   Salad    13  181 

Nut  Tomato  Toast    33  205 

Whole-wheat  Gems   (2)    30  192 

Honey  (2  teaspoons)   50 

Celery   and  Broth    15  45 

Per  cent  of  protein  for  the  meal,  13V2. 

673 

For  recipes,  see  Chapter  XXXI. 

There  may,  of  course,  be  many  variations  in  the  fruit 
salad.  The  following  is  good:  Cut  up  apples,  bananas, 
oranges,  add  chopped  nuts  and  raisins.  A  sweet  dress- 
ing, if  desired,  may  be  made  by  adding  honey  to  orange 
juice.  Eat  the  celery  raw.  Cook  the  celery  tops  with 


212  THE    HOME   DIETITIAN 

a  little  onion  and  tomato,  and  serve  the  broth  salted  to 
taste  as  a  hot  drink. 

Protein  Total 

No.   2                                                                                                   Calories  Calories 

Grapefruit  Salad    25  275 

Baked  Oats  with  Pea  Tomato  Sauce   35  170 

Stuffed  Dates   (6)    Stuffed  with  Almonds   20  250 

Orange  Juice    ( 7  oz. )    7  100 

Per  cent  of  protein  for  the  meal,  11.  

87  795 

Make  salad  as  given  above,  using  almonds.  Remove 
pulp  from  grapefruit  and  use  grapefruit  instead  of 
orange.  Add  honey  to  grapefruit  juice  and  use  as  dress- 
ing. Serve  salad  in  grapefruit  skin.  (See  recipe  76.) 
Add  to  a  cup  of  oatmeal  enough  water  to  cover  it,  then 
salt.  Let  stand  all  night.  In  the  morning  bake  slowly 
one  hour.  To  two  cups  of  pea  puree,  add  a  cup  of  strained 
tomato,  salt  to  taste.  Heat  and  serve  over  oatmeal. 

Protein  Total 

No.    3  Calories  Calories 

Whole  Grapefruit  with  Honey    10  150 

Nut  Tomato  Rice  with  Lettuce    26  206 

Whole-wheat  Sticks   (4)    (or  gems)    14  144 

Stuffed  Prunes   (4)    12  100 

Per  cent  of  protein  for  the  meal.  11. 

62  600 

Prepare  grapefruit  the  evening  before.  Loosen  the 
pulp  and  add  a  teaspoon  of  honey  to  each  half.  Pre- 
pare nut  tomato  sauce  as  for  nut  tomato  toast  and  serve 
with  boiled  rice.  Or  for  this  dish  may  be  substituted 
macaroni,  boiled,  then  baked  in  the  same  sauce.  (See 
recipes  54  and  55.)  For  stuffed  prunes,  prepare  as  for 
stuffed  dates,  using  almonds  or  walnuts. 

Protein  Total 

No.    4  Calories  Calories 

Orange   Juice    (7    oz.)     7  100 

Apple  and  Celery  Salad    5  75 

English   Walnuts    (6)     20  200 

Cream  Rolls   (3)    18  126 

Hot  Malted  Nuts   t 27  150 

Per  cent  of  protein  for  the  meal,  12.  

77  651 


VEGETARIAN  DIET  WITHOUT  DAIRY  PRODUCTS        213 

To  prepare  hot  malted  nuts,  see  recipe  104.  To  make 
salad,  dice  one  apple  and  add  to  two  stalks  of  chopped 
celery.  The  walnuts  may  be  chopped  and  added  to 
salad,  or  may  be  served  alone.  Save  celery  tops  for 
vegetable  broth  or  soup. 

Protein  Total 

No.    5  Calories  Calories 

Orange   Juice    (7    oz. )     7  100 

String  Beans  on  Graham  Toast   (vegetable  butter)   20  145 

Almonds     (12)     35  200 

Banana     7  100 

Per  cent  of  protein  for  meal,   13.  

Protein  Total 

No.    6  Calories  Calories 

Orange  Juice    (7   oz. ) 7  100 

Corn  Bread    18  130 

Vegetable  Butter    50 

Protose  and  Potato  Hash   50  150 

Asparagus    (large    serving)     8  25 

Baked  Apple    T~  125 

English  Walnuts    10  100 

Per  cent  of  protein  for  the  meal,  14. 

95  680 

Make  corn  bread  according  to  recipe  3.  Vegetable 
butter  can  usually  be  procured  at  any  grocery,  under  the 
name  nut  margarine.  Make  the  protose  and  potato 
hash  according  to  recipe  46. 

Protein  Total 

No.    7                                                                                                       Calories  Calories 

Fruit  Salad  with  Lettuce    20  300 

Puree  of  Green  Peas  on  Toast   29  150 

Whole-wheat  Sticks    (4)    14  144 

Hot  Peanut  Milk    (6  oz.)    17  120 

Per  cent  of  protein  for  the  meal,  11.  

This  is  a  large  fruit  salad.  To  make  each  individual 
salad,  use  half  a  banana,  an  apple,  an  orange,  three  or 
four  walnuts,  and  about  ten  raisins.  Serve  with  lettuce. 
For  the  puree,  use  fresh  peas,  cook  them,  press  through  a 
colander,  season  with  a  little  strained  tomato.  Salt  to 
taste.  Moisten  zwieback  in  hot  water,  butter  with  vege- 


214  THE    HOME   DIETITIAN 

table  butter,  and  cover  with  the  puree.  To  make  the  pea- 
nut milk,  emulsify  a  tablespoonf ul  of  peanut  butter,  add- 
ing water  gradually  up  to  six  ounces.  As  the  water  is 
being  added,  stir  in  a  third  of  a  teaspoonful  of  honey. 

Sample  Dinner  Menus 

Protein  Total 

No.    1  Calories  Calories 

Bean  Tomato  Soup   (8  oz.)    37  160 

Zwieback    (2)    28  200 

Spinach    (large    serving)     15  50 

Browned  Potatoes    18  150 

Carrot   and    Nut   Salad    22  125 

Caramel    Pudding    5  150 

Per  cent  of  protein  for  the  meal,  13.  • 

BI  •    ,  125  835 

Prepare  soup  stock  according  to  recipe  25.  To  a  pint 
of  this  soup  stock,  add  a  pint  of  strained  tomato  and 
two  pints  of  bean  puree.  The  water  from  the  spinach 
may  also  be  added.  Make  zwieback  from  whole-wheat 
bread.  For  browned  potatoes,  use  recipe  59.  For  each 
individual  salad,  use  one  carrot  grated  and  six  almonds 
chopped.  Add  a  French  dressing.  See  recipe  86.  For 
the  caramel  pudding,  make  a  fruit  sauce.  See  recipes 
107  and  93. 

Protein  Total 

No.   2  Calories  Calories 

Vegetable    Bouillon 24  93 

Zwieback    (2)    28  200 

Baked    Puree   of   Lentils   with    Nut   Tomato    Sauce  50  200 

Mashed   Turnips    (3   tablespoons)    3  10 

Lettuce    3  10 

Farina  Mold  with  Nuts  and  Raisins 35  269 

Per  cent  of  protein  for  the  meal,  19. 

143  782 

For  bouillon,  see  recipe  23,  but  use  broth  from  lentils 
instead  of  bean  broth.  Turnip  water  may  also  be  sub- 
stituted for  potato  water.  Cook  one  cup  of  lentils, 
drain  well,  press  through  a  colander.  Two  tablespoons 
of  grated  onion  and  */2  CUP  of  zwieback  crumbs  wet  up 


VEGETARIAN  DIET  WITHOUT  DAIRY  PRODUCTS        215 

with  tomato  juice  may  be  added.  Salt  to  taste.  Bake 
slowly  in  oven  for  30  minutes.  Any  other  legumes  may 
be  used  instead  of  lentils.  Serve  with  sauce  made  ac- 
cording to  recipe  69.  (See  also  recipe  58.)  For  farina 
mold,  use  recipe  92,  but  add  to  this  a  dozen  nuts  chopped 
and  about  four  dozen  raisins. 

Protein      Total 
No.  3  Calories     Calories 

Tomato  Corn  Soup    30  169 

Zwieback    (2)    28  200 

Baked  Lima  Beans    32  150 

Mashed   Potatoes    10  106 

Cauliflower     7  12 

Combination   Salad    7  35 

Stuffed  Dates    (4)    8  100 

Grape  Juice   (7  oz.)    2  100 

Per  cent  of  protein  for  the  meal,  14.  

124  872 

For  soup,  add  to  one  cup  of  potato  soup  stock  one 
can  of  tomatoes  strained  and  one  can  of  corn  (with  or 
without  pureeing).  Thin  with  water  from  the  cauli- 
flower. Salt  to  taste.  Boil  the  Lima  beans  one  hour, 
then  place  in  oven  and  bake.  Prepare  potatoes  early  so 
that  the  broth  from  the  skins  may  be  added  to  the  Lima 
beans  when  they  are  put  in  to  bake.  The  beans  will 
need  no  other  seasoning  than  salt. 

Protein  Total 

No.    4  Calories  Calories 

Tomato  Gluten   Soup    23  103 

Zwieback    (2)    28  200 

Braised  Protose    49  110 

Beets  with  the  Tops  8  40 

Stuffed    Potatoes    15  150 

Celery    (3  stalks)    5  20 

Olives     (5)     5  100 

Per  cent  of  protein  for  the  meal,  18. 

133  723 

For  the  soup,  use  two  cans  of  tomatoes,  strained. 
Add  to  this  a  pint  or  more  of  the  water  in  which  the 
beets  are  cooked.  Salt  to  taste  and  thicken  as  desired 


216  THE    HOME   DIETITIAN 

with  20-per-cent  gluten.  (See  also  recipe  29.)  Any  other 
vegetable  water  may  be  used  instead  of  the  beet  broth, 
or  simply  the  tomato  may  be  used.  For  protose  and 
stuffed  potatoes,  see  recipes  44  and  61. 

Protein  Total 

No.    5  Calories  Calories 

Protose  and  Potato  Hash    50  150 

Baked    Squash    3  43 

Lettuce  and  Tomato   Salad    10  35 

Graham   Bread    14  100 

Vegetable  Butter    50 

Cereal    Pudding    12  275 

Orange    Juice    5  75 

Almonds    (6)     15  100 

Per  cent  of  protein  for  the  meal,   13. 

109  828 

For  the  hash,  mix  potatoes  and  protose  in  the  pro- 
portion of  three  potatoes  to  one-half  can  of  protose;  chop 
and  mix  thoroughly;  warm  in  an  oiled  pan  or  bake  in  a 
slow  oven.  Chopped  onion  may  be  added.  (See  also 
recipe  46.)  Make  the  salad  according  to  recipe  78  and 
serve  with  French  dressing. 

Protein  Total 

No.    6                                                                                                       Calories  Calories 

Tomato    Bisque     14  75 

Zwieback    (2)    28  200 

Bean  Croquettes    ( 2 )    58  238 

Spinach    ( large  serving )    15  50 

Orange  Jelly    2  97 

English    Walnuts    (4)     13  '  130 

Per  cent  of  protein  for  the  meal,  16.  • 

130  790 

Make  the  tomato  bisque,  bean  croquettes,  and  orange 
jelly  according  to  recipes  36,  40,  and  100. 

Protein  Total 

No.    7  Calories  Calories 

Vegetarian  Consomme    36  65 

Zwieback    (2)     28  200 

Green  Peas    (4  tablespoons)    28  114 

Mashed   Potatoes    15  150 

Lettuce  and  Carrot  Salad   .                               4  20 


VEGETARIAN  DIET  WITHOUT  DAIRY  PRODUCTS        217 

Almonds    (6)     15  100 

Dates    (4)     1  100 

Per  cent  of  protein  for  the  meal,  15.  

127  749 

To  make  the  vegetarian  consomme,  boil  the  potato 
skins;  strain,  add  the  water  in  which  the  potatoes  are 
cooked  and  the  green  pea  water.  Strain  the  contents  of 
a  can  of  tomatoes  and  add  to  the  above.  Care  should  be 
taken  that  the  consomme  is  not  too  watery.  This  can 
be  avoided  by  adding  only  enough  water  to  the  vege- 
tables to  cook  them  and  leave  a  concentrated  broth.  (See 
also  recipe  37.)  After  the  potatoes  have  been  thoroughly 
mashed,  add  for  seasoning  a  peanut  cream  made  by 
emulsifying  peanut  butter  in  enough  water  to  make  it 
the  consistency  of  milk  or  cream. 

The  rather  high  protein  percentage  of  the  dinner 
menus,  it  may  be  noted,  tends  to  balance  the  lower  pro- 
tein content  of  the  breakfast.  For  those  who  need  more 
calories  at  a  meal,  the  servings  may  be  larger.  If  more 
protein  is  needed,  the  servings  of  the  protein  foods  may 
be  increased.  There  is  still  a  third  meal  to  be  had, 
which  may  be  made  to  furnish  extra  protein  or  energy 
food,  as  required.  This  third  meal  should  be  simple 
and  include  a  goodly  portion  of  fruit  or  of  fruit  and 
raw  vegetable  salad.  In  addition  to  this,  a  vegetable 
broth  or  soup  may  help  to  increase  the  valuable  vege- 
table elements  upon  which  we  must  to  a  great  extent 
depend  to  take  the  place  of  milk.  This,  with  Graham 
bread  or  zwieback,  will  be  found  very  satisfactory.  A 
half  dozen  almonds  eaten  with  this  meal  will  add  15 
calories  of  good  protein. 

The  above  menus  are  only  suggestive,  and  serve  to 
show  possibilities  for  satisfactory  and  nourishing  meals 
without  the  use  of  dairy  products. 


CHAPTER  XXV 

PRINCIPLES  OF  FEEDING  THE  SICK,  AND  THEIR 
APPLICATION  IN  ACUTE  DISEASE 

OUR  aim  in  this  chapter,  and  in  those  immediately 
following,  is  not  in  any  sense  to  give  a  complete  out- 
line of  the  diet  in  any  of  the  many  and  varied  forms  of 
acute  or  chronic  disease.  Our  space  will  not  permit, 
neither  do  we  feel  that  such  an  outline  should  be  in- 
cluded within  the  scope  of  a  book,  the  contents  of 
which  are  suggested  by  a  title  such  as  has  been  given 
to  this.  The  diet  in  any  disease  should  be  suggested  by 
the  physician  in  charge,  along  with  lines  of  treatment 
other  than  dietetic.  However,  there  are  so  many  fads 
in  connection  with  dietetic  treatment  of  disease,  and 
withal,  such  a  woeful  lack  among  mothers  and  house- 
wives, of  a  knowledge  of  scientific  principles  of  feeding, 
even  in  the  most  common  of  ailments,  that  we  do  not 
feel  that  we  are  too  greatly  exceeding  our  bounds  in 
showing  how  the  principles  of  dietetics  should  be  applied 
under  conditions  of  sickness  and  ill  health.  We  would 
seek  to  show  that  the  principles  are  the  same  and  the 
difference  of  application  not  great.  The  important, 
underlying  principles  of  feeding,  in  sickness  as  well 
as  in  health,  we  believe,  should  be  understood  by  every 
homekeeper. 

The  Same  Foods  Needed  in  Sickness  as  in  Health 

When  a  person  is  sick,  it  is  quite  as  important  as  it 
is  when  he  is  well,  that  his  body  be  supplied  with  all 
the  food  essentials.  The  great  differences  are,  first, 
that,  because  of  inactivity,  his  caloric  needs  are  less; 
and,  second,  that  the  more  or  less  weakened  condition 

218 


PRINCIPLES   OF   FEEDING   THE   SICK  219 

of  the  digestive  organs  makes  it  necessary  that  his  food 
be  given  him  in  a  very  easily  digested  form. 

As  is  well  known,  of  all  food  elements,  the  body  soon- 
est suffers  from  an  insufficient  supply  of  water,  and 
this  should  always  be  supplied  freely. 

Constant  Food  Essentials 

After  this  the  fairly  constant  food  essentials  in  health 
are,  (1)  vitamines,  (2)  mineral  salts,  and  (3)  proteins. 
The  normal  variation  in  the  diet  of  any  two  individuals 
is  in  the  amount  of  starch,  sugar,  and  fat  they  may  need 
to  make  up  their  total  caloric  food  requirements,  this 
being  dependent  upon  their  height,  habits,  and  tissue 
activity.  The  enforced  inactivity  of  the  one  who  is  sick 
automatically  lessens  his  caloric  food  requirements, 
which  obviously  should  mean  a  lowering  of  his  intake  of 
carbohydrates  and  fats,  the  strictly  energy  foods. 

Vitamines,  Salts,  Protein 

Vitamines,  with  their  vitalizing  power,  he  may  need 
even  more  than  in  health;  of  mineral  salts,  with  their 
alkalizing  properties  (see  Chapter  X),  he  has  an  espe- 
cial need,  for  ever  in  sickness  the  body  tends  toward  a 
condition  of  acidity,  making  it  more  difficult  for  it  to 
maintain  its  normal  degree  of  alkalinity;  and  of  protein, 
the  tissue  restorer,  he  cannot  be  long  without,  because 
of  the  extra  tissue  waste  so  often  accompanying  the 
process  of  disease.  The  supply  of  carbohydrates  and 
fats  needed  depends  upon  the  length  of  the  illness,  the 
power  of  the  patient  to  digest  and  assimilate  food,  and 
the  degree  of  the  body  and  tissue  activity. 

Food  in  What  Form? 

The  kinds  of  food  required  having  been  decided  upon, 
the  form  in  which  the  food  is  to  be  given  is  of  great 
importance,  and  this  depends  upon  the  ease  with  which 


220  THE    HOME   DIETITIAN 

the  patient  is  able  to  digest  food.  As  a  rule,  however, 
food,  simply  prepared,  not  too  rich,  and  of  a  kind  and 
form  that  is  easily  digested,  is  the  best.  The  likes  and 
dislikes  of  the  patient  should  be  considered  and  should 
have  an  influence  in  so  far  as  they  do  not  affect  the 
healthfulness  of  his  food  and  the  good  that  he  may  de- 
rive from  it.  It  is  well  known  that  other  things  being 
equal,  the  keener  the  relish  for  food,  the  greater  the 
good  the  system  is  able  to  get  from  it. 

The  Food  Quartet 

In  all  cases  of  feeding,  it  is  important  that  the  follow- 
ing foods  be  included  in  the  dietary:  (1)  Fruits,  (2) 
vegetables,  (3)  milk,  (4)  cereals.  With  this  simple 
quartet  it  is  possible  to  furnish  a  well-balanced  ration, 
whether  the  one  who  eats  be  sick  or  well.  If  any  one 
of  the  four  be  lacking,  the  diet  is  open  to  question,  and 
should  be  carefully  investigated.  With  every  individual 
patient  we  may  be  called  upon  to  feed,  we  are  to  ex- 
amine his  diet  with  reference  to  these  four  foods.  Are 
they  included  in  his  dietary?  If  not,  why  not?  This  is 
not  to  say  that  the  diet  of  every  acutely  sick  person 
should  include  all  of  these,  for  there  are  cases  where, 
for  a  very  short  period,  nothing  perhaps,  not  even  water, 
should  be  allowed  to  enter  the  stomach,  as  in  some  cases 
of  acute  appendicitis,  where,  for  any  reason,  operation 
is  delayed;  and,  as  has  been  said  in  Chapter  XXII,  there 
are  times  and  conditions  of  auto-intoxication,  acute  or 
chronic,  where  complete  absence  of  food  for  a  few  days 
may  result  in  great  benefit. 

Colds 

In  short,  acute  illnesses,  as  in  colds,  tonsillitis,  etc.,  a 
diet  limited  for  a  short  time  to  fruit  juices,  or  to  fruit 
juices  and  vegetable  broths,  with  the  vitamines  and  min- 
eral salts  thus  supplied,  may  be  the  very  best  that  can 


PRINCIPLES   OF   FEEDING   THE   SICK  221 

be  planned;  but  whenever  the  invalid  state  becomes  at 
all  protracted,  a  thorough  study  should  be  made  to  de- 
termine whether  or  not  there  are  being  given  all  the 
food  elements  necessary  to  keep  the  body  in  the  best 
possible  state  of  nutrition,  and  thus  hasten  recovery. 

In  what  forms,  then,  shall  the  foregoing  foods  — 
fruits,  vegetables,  milk,  and  cereals  —  be  supplied  to  the 
acutely  ill  person?  What  is  the  order  of  their  impor- 
tance as  regards  the  body  need  and  ability  to  utilize 
them  under  the  stress  of  illness? 

Fruit  Juices 

Fruit  juices  are  of  the  utmost  importance  in  the  feed- 
ing of  the  sick.  First,  they  are  a  help  in  supplying  the 
large  amount  of  water  so  often  needed.  Second,  they 
are  rich  in  vitamines,  without  a  free  supply  of  which 
the  body  would  often  be  unable  to  cope  successfully  with 
disease.  Third,  they  furnish,  in  spite  of  their  naturally 
acid  properties,  certain  alkalinizing  salts  (see  Chapter 
X),  which  help  to  maintain  the  normal  reaction  of  the 
blood  against  the  excess  of  acid  wastes  that  so  often,  in 
illness,  rapidly  accumulate.  Fourth,  they  contain  actual 
caloric  food  value,  in  a  predigested  form,  and  easily  as- 
similated. Fifth,  the  fruit  acid  is  a  natural  disinfectant 
and  cleanser,  and  also  stimulates  normal  peristaltic  ac- 
tion, thus  helping  to  prevent  a  stagnant  condition  of 
the  digestive  tract. 

In  many  an  illness,  if  not  too  protracted,  a  patient 
may  be  carried  through  on  a  diet  of  fruit  juices.  In 
this  way  a  caloric  intake  of  from  six  hundred  to  one 
thousand  calories  daily  can  easily  be  given,  and  this  in 
the  form  of  dextrose,  which  imposes  no  tax  on  the  di- 
gestive powers,  but  being  quickly  picked  up  by  the  blood 
stream  and  at  once  utilized  in  the  tissues,  acts  as  the 
natural  stimulant  the  body  so  much  needs.  Fruit  juices 


222  THE    HOME   DIETITIAN 

should  be  first  thought  of  when,  for  any  reason,  a  pa- 
fcient's  diet  needs  to  be  greatly  restricted,  and  unless 
there  be  some  special  contraindication,  should  be  in- 
cluded, no  matter  how  much  other  food  he  may  be  able 
to  take.  It  is  better  not  to  add  sugar  to  these  juices. 

Vegetable  Broths 

Ranking  with  fruit  juices  in  their  importance,  and 
making  a  most  valuable  addition  to  the  aforementioned 
diet,  are  vegetable  broths.  These  furnish,  first,  vita- 
mines,  thus  re-enforcing  the  vitamines  supplied  by  the 
fruit  juices,  and  in  case  the  fruit  juices  are  for  any 
reason  not  being  given,  may  be  made  of  themselves  to 
supply  a  sufficient  quantity  of  these  life-giving  ferments. 

Second,  they  supply  mineral  salts,  and  these,  seem- 
ingly in  greater  quantities  and  in  more  varied  forms 
than  fruit  juices  do.  They  furnish  such  important  min- 
eral elements  as  calcium,  iron,  phosphorus,  and  potas- 
sium, which  not  only  work  with  the  fruit  juices  in  main- 
taining body  alkalinity,  but  also  enter  largely  into  the 
formation  of  body  tissues.  (See  Chapter  X.) 

Third,  a  certain  amount  of  protein  is  also  furnished 
by  vegetable  broths,  the  amount  being  dependent  on  its 
preparation.  A  cup  of  vegetable  broth,  made  after 
recipe  24,  may  contain  19  protein  calories  to  a  total  of 
46  calories,  or  41  per  cent  protein.  This  gives  an  added 
value  of  very  greatest  importance,  because  of  the  great 
need  in  sickness  of  tissue-building  food,  and  the  neces- 
sity for  supplying  it  in  an  easily  assimilated  form. 

The  proteins  of  vegetable  broths  are  complete  (see 
Chapter  VI),  and  furnishing  as  they  do  the  important 
trio,  vitamines,  mineral  salts,  and  complete  proteins, 
they  supply  to  the  body  in  a  form  most  easily  utilized, 
the  food  elements  essential  for  sustaining  life.  Used  in 
connection  with  fruit  juices,  with  the  added  carbohy- 
drate content  of  the  fruit  juices,  they  furnish  to  the 


PRINCIPLES   OF   FEEDING   THE   SICK  223 

acutely  sick  patient,  whose  vital  powers  must  all  be  used 
in  fighting  disease,  the  first  and  perhaps  the  only  essen- 
tial foods  necessary  to  carry  the  fight  to  a  victorious 
finish.  In  some  cases,  when  the  stomach  is  irritable, 
or  when  it  seems  best  to  limit  the  peristaltic  activity  of 
the  bowel,  as  after  abdominal  surgery,  vegetable  broths 
may  be  taken  better  for  a  time  than  fruit  juices.  Veg- 
etable broths  alone  may  sustain  the  patient  for  many 
days,  fruit  juices  being  added  as  soon  as  the  patient 
can  take  them. 

The  value  of  these  vegetable  juices  has  not  been  fully 
appreciated,  but  should  be  well  understood  by  every  one 
having  anything  to  do  with  the  feeding  of  the  sick. 
They  should  in  some  form  have  a  place  in  every  invalid 
dietary,  and  in  some  acute  conditions  may  be  the  only 
food  a  patient  can  take.  (See  recipes  in  Chapter  XXXI.) 

Additional   Calories 

Our  patient,  then,  during  the  height  of  his  acute  ill- 
ness, has  had  supplied  to  him  through  the  medium  of 
fruit  juices  and  vegetable  broths  the  vital  trio, —  vita- 
mines,  mineral  salts,  and  complete  proteins, —  but  as  the 
days  go  by  it  should  be  remembered  that  such  a  limited 
diet  has  been  only  for  an  emergency,  and  that  he  soon 
must  have  additional  calories  supplied  him,  especially 
in  the  way  of  protein.  Otherwise,  his  system  will  suf- 
fer for  want  of  sufficient  protein  food  to  take  the  place 
of  excessive  body  waste.  His  total  calories  must  also 
be  increased. 

Importance  of  Milk 

Therefore,  the  food  next  in  importance,  and  one  which 
should  be  added  as  soon  as  possible,  is  milk.  Milk  is  a 
food  of  great  value.  It  supplies,  first,  protein,  and  that 
in  the  form  of  complete  protein ;  second,  fat  in  an  emul- 


224  THE    HOME   DIETITIAN 

sified  form,  the  form  in  which  fat  is  most  easily  di- 
gested; third,  carbohydrate  in  the  form  of  milk  sugar; 
fourth,  mineral  salts;  fifth,  vitamines.  Because  of  the 
completeness  of  its  food  content,  milk  has  been  called  a 
protective  food.  (See  Chapters  XIV  and  XXVIII.) 

Boiled   Milk 

The  sooner  milk  can  be  added  to  the  diet  of  the  pa- 
tient, the  sooner  will  it  be  possible  for  the  body  to  be 
restored  to  its  normal  state.  But  milk  often  makes 
trouble.  In  its  raw  state  it  is  sometimes  difficult  of 
digestion.  Because  of  the  large  curds  which  form  in 
the  stomach  as  a  result  of  the  action  of  the  gastric  juice 
on  the  milk,  it  must  be  considered  a  solid  food.  For 
this  reason  many  invalids  who  need  the  food  value  of 
milk  seem  unable  to  take  it  well.  But  it  must  be  re- 
membered that  milk  can  be  taken  in  several  different 
forms.  Milk  can  be  changed  from  a  solid  food,  compar- 
atively difficult  of  digestion,  to  a  relatively  liquid,  easily 
digested  food,  by  boiling.  Milk  that  has  been  boiled 
forms  in  the  stomach  fine,  flaky  curds.  These  fine  curds 
are  nonirritating  and  easily  mixed  with  the  gastric  juice. 
It  is  true  that  we  must  consider  a  certain  deterioration 
in  the  vitamine  content  due  to  the  heating  of  the  milk, 
but  if  the  milk  is  fresh  and  boiled  not  longer  than  three 
minutes,  and  served  soon  after  boiling,  this  deterioration 
is  slight.  At  any  rate,  because  of  the  abundance  of  vita- 
mines  supplied  the  invalid  in  the  way  of  fruit  juices  and 
vegetable  broths,  we  need  have  no  fear  as  to  his  getting 
enough  of  this  valuable  element.  The  protein,  fat,  and 
carbohydrates  of  boiled  milk  are  quite  as  valuable  as  that 
in  raw  milk  and  are  in  a  form  that  can  be  well  cared 
for,  even  by  one  with  a  weak  digestion.  The  boiling  of 
the  milk  greatly  increases  the  digestibility  of  its  protein. 

That  part  of  milk  often  the  most  difficult  of  digestion 
is  fat.  Therefore,  skim  milk  is  a  simpler,  more  easily 


PRINCIPLES  OP  FEEDING  THE  SICK  225 

digested  food  than  whole  milk,  and  in  some  cases  when 
milk  is  first  given  it  is  well  to  give  it  as  skim  milk, 
gradually  adding  the  cream  later.  Often  in  cases  of 
severe  illness,  as  in  fevers,  the  diet  problem  may  be 
solved  by  the  use  of  the  three  foods,  fruit  juices,  vege- 
table broths,  and  boiled  skim  milk,  the  skim  milk  sup- 
plementing the  low-protein  content  of  the  first  two. 
The  added  food  value  of  the  fat  in  the  actual  calories 
which  it  contains  may  mean  much  in  protracted  illness, 
and  the  cream  of  the  milk  should  be  given,  if  it  in  no 
way  interferes  with  the  utilization  of  the  other  foods. 
However,  it  must  be  borne  in  mind  that  in  acute  ill- 
nesses, fevers  and  infections,  fat  is  usually  not  well 
borne,  and  often,  for  a  time  at  least,  has  to  be  excluded 
from  the  diet. 

Buttermilk 

Buttermilk  is  a  very  good  form  in  which  to  give  milk. 
It  supplies  all  the  elements  except  the  fat,  and  the 
lactic  acid  content  of  the  milk  tends  to  inhibit  intestinal 
putrefaction. 

Cereal 

Our  simplest  steps  having  been  enumerated,  we  have 
reached  the  last  mentioned  of  our  essential  food  quar- 
tet, that  is,  cereal.  In  cereal  we  have  a  valuable  means 
of  adding  caloric  food  value.  By  this  addition  we  are 
able  to  bring  our  patient's  daily  ration  up  to  the  total 
food  value  needed  to  overcome  his  more  or  less  ema- 
ciated condition  and  restore  him  to  health  and  strength. 
That  cereal  has  a  distinctive  food  value  of  its  own,  apart 
from  simply  its  calories,  cannot  be  gainsaid,  for  it  has 
been  shown  that  babies  have  often  gained  in  weight 
when  cereal  has  been  added  to  their  diet,  even  though 
the  addition  of  the  cereal  has  been,  to  a  large  extent, 
substitution  and  not  necessarily  an  increase  in  the  total 
calories. 

15 


226  THE  HOME  DIETITIAN 

But  in  what  form  should  cereal  be  given  to  one  whose 
digestive  organs  have  been  weakened  by  illness?  Dex- 
trinized  cereals,  or  cereals  in  which  the  starch  has  been 
changed  to  dextrin,  the  first  step  in  starch  digestion,  are 
the  best.  Dextrinized  cereal  may  be  made  into  gruels, 
as  corn-flake  gruel,  wheat-flake  gruel,  shredded-wheat 
gruel;  or  it  may  be  given  as  zwieback,  dry,  or  as  milk 
toast.  Gruels  may  also  be  made  from  nondextrinized 
cereals,  as  oatmeal,  cream  of  wheat,  rice,  and  others,  if 
they  are  sufficiently  well  cooked.  After  thorough  cook- 
ing, they  should  be  strained,  properly  thinned,  usually 
with  the  addition  of  milk,  not  cream.  Evaporated  milk 
may  often  be  added  to  these  cereal  gruels,  with  pleasing 
results  and  without  the  disadvantages  of  cream.  Zwie- 
back (oven  toast)  is  often  the  first  solid  food  well 
borne.  It  may  be  allowed  very  early  with  vegetable 
broth,  or  with  boiled  milk. 

Other  Foods 

When  our  acutely  sick  patient  has  reached  the  place 
where  these  forms  of  the  essential  food  quartet  —  fruits, 
as  fruit  juices;  vegetables,  as  vegetable  broths;  milk,  as 
boiled,  skim,  or  buttermilk;  cereals,  as  zwieback  or  dex- 
trinized  gruels  —  can  be  given  him,  his  diet  possibilities 
are  complete,  and  the  only  other  forms  of  foods  that 
we  need  to  consider  for  him  are  the  various  combina- 
tions and  the  more  solid  varieties  of  these  same  four 
foods. 

To  his  fruit  juices  may  be  added  the  fruits  themselves, 
it  ever  being  remembered  that  stewed  and  dried  fruits, 
while  good  for  furnishing  calories,  can  never  be  made  to 
quite  take  the  place  of  fresh  fruits  or  juices.  To  the 
vegetable  broths  may  be  added  the  vegetables,  first  as 
soups  and  purees,  then  as  the  more  tender  vegetables. 
Baked  potatoes,  asparagus  tips,  spinach,  tomatoes,  tender 
green  peas,  and  others  may  be  gradually  added.  Milk 


PRINCIPLES   OF   FEEDING   THE   SICK  227 

may  be  combined  with  vegetable  purees  to  make  appetiz- 
ing cream  soups.  With  boiled  milk  may  be  allowed  some 
raw  milk,  if  the  patient  prefers  and  if  he  can  take  it 
well.  Cottage  cheese  is  a  valuable  form  in  which  to 
supply  milk  protein.  It  may  be  served  as  cottage  cheese 
omelet  (see  recipe  48)  ;  or  it  may  be  served  with  cream, 
thus  making  its  food  value  approximate  that  of  whole 
milk.  Eggs,  though  not  mentioned  as  one  of  the  four 
essential  foods,  find  their  place  here,  and  may  take  their 
turn  with  milk,  preferably  soft  boiled  or  poached. 

Instead  of  limiting  the  cereal  part  of  his  food  simply 
to  cereals  and  zwieback,  we  may  allow  him  a  piece  of 
bread  (thirty-six  hours  old)  and  we  may  venture  for 
him  a  bit  of  breakfast  mush.  However,  as  long  as  he 
remains  an  invalid,  even  though  a  convalescent  one,  it 
must  be  remembered  that  he  can  take  more  calories  in 
the  form  of  zwieback  and  gruel  than  in  the  form  of 
bread  or  mush,  because  of  the  greater  ease  to  digest 
the  first-mentioned  form  of  foods. 

As  he  becomes  a  convalescent,  his  total  calories  must 
be  brought  up  to  the  amount  necessary  to  restore  him 
to  his  normal  weight  and  strength.  The  wasted  patient 
will  need  extra  protein  calories  to  restore  tissue.  These 
may  well  be  supplied  in  milk,  eggs,  cottage  cheese,  al- 
monds (if  well  masticated),  gluten  gruel,  whole- wheat 
bread,  vegetable  soup  in  which  skins  and  leaves  of  vege- 
tables are  utilized,  and  in  purees  of  legumes,  as  Lima 
beans,  green  peas,  etc.,  and  for  those  who  feel  that  they 
must  have  it,  a  moderate  amount  of  the  least  harmful 
meat,  as  mutton,  lamb,  and  chicken.  Extra  calories  for 
energy  and  to  replace  wasted  fatty  tissue  may  be  sup- 
plied, not  only  in  connection  with  the  aforementioned 
foods,  but  also  as  sweets  in  the  form  of  honey,  meltose, 
dates,  and  other  dried  and  stewed  fruits,  as  prunes,  figs, 
apple  sauce,  and  baked  apple. 


228  THE  HOME  DIETITIAN 

Free  Fat 

Fat,  the  most  concentrated  food,  is  best  furnished  in 
milk  with  its  cream,  in  olives,  and  in  nuts.  Free  fat 
should  be  used  sparingly  in  all  cases  of  illness,  for  non- 
emulsified  fat  is  ever  a  deterrent  to  digestion.  During 
the  acute  stage  of  illness,  no  cream  (except  as  given  in 
whole  milk),  butter,  or  other  free  fats  should  be  allowed. 
In  some  cases,  milk  may  be  taken  if  partly  or  wholly 
skimmed,  when  the  addition  of  the  cream  might  make  it 
impossible  for  the  patient  to  utilize  the  milk. 

In  convalescence,  whole  milk  should  be  given,  if  pos- 
sible, and  in  some  cases  some  extra  cream  may  be  added. 
This,  however,  should  be  done  carefully.  The  number 
of  calories  needed  daily  must  depend  upon  the  needs  of 
the  patient,  the  degree  of  emaciation,  his  activity,  and 
his  ability  to  care  for  the  food  ingested. 

It  should  ever  be  borne  in  mind  that  only  food  prop- 
erly digested  can  be  utilized.  The  more  easily  digested 
the  food,  the  more  calories  will  the  patient  be  able  to 
care  for;  and  if  overeating  is  bad  in  health,  it  is  surely 
worse  in  disease. 

The  above-mentioned  foods  do  not  cover  all  the  foods 
that  may  be  allowed  the  invalid  in  every  case,  but  the 
outline  forms  a  working  basis  which  may  serve  as  a 
check-up  on  the  dietary  essentials,  and  to  these  may  be 
added  other  things  as  the  patient  desires  and  seems  able 
to  take. 

Questionable   Foods 

Foods  questionable  in  health,  should,  of  course,  not  be 
allowed  in  disease,  and  dishes  should  ever  be  prepared 
with  due  regard  for  simplicity,  both  as  to  the  individual 
dish  and  the  variety  served  at  one  time.  During  the 
height  of  the  illness  one  dish,  as  fruit  juice,  a  vegetable 
broth,  a  soup,  or  a  gruel,  should  be  served  at  a  time; 


PRINCIPLES   OF   FEEDING   THE   SICK  229 

while  during  convalescence  a  simple  variety  of  two  or 
three  simple  dishes  is  often  better  than  a  greater  num- 
ber of  foods  served  at  the  same  meal. 

Frequency  of  Feeding 

While  the  patient  is  able  to  take  only  a  liquid  diet, 
it  is  usually  necessary  to  feed  him  more  frequently,— 
sometimes  every  two  hours,  or  even  oftener,  dependent 
upon  the  amount  taken  at  one  time.  If  his  diet  is  lim- 
ited to  fruit  juices  or  vegetable  broths,  these  may  be 
given  freely  as  often  as  every  half  hour.  It  should  be 
remembered  that  no  rule  can  be  given  that  will  hold 
good  in  every  case,  and  that  there  are  exceptions  to  all 
rules.  However,  with  a  working  knowledge  of  dietetics, 
and  of  the  principles  as  outlined  in  this  chapter,  the 
problems  of  feeding  the  sick  are  greatly  simplified,  and 
the  resources  of  the  one  bearing  the  responsibility 
greatly  increased.  And  without  a  knowledge  of  these 
principles  a  given  diet  for  any  given  disease  may  be  all 
wrong  for  an  individual  patient,  for  we  must  feed  the 
patient  and  not  the  disease. 

Practical  Application 

So,  if  Mary  has  a  cold,  increase  her  vitamines,  lessen 
her  calories,  and  give  her  only  the  simplest  food.  For 
twenty-four  to  forty-eight  hours  (some  cases  longer), 
limit  her  to  orange  juice  with  lemon  and  other  fruit 
juices,  and  vegetable  broths.  Then  add  boiled  milk  and 
hot  milk  toast,  or  cream  soup  (see  recipes,  Chapter 
XXXI)  with  hard  toast.  See  that  she  has  water  freely. 
After  this,  and  until  her  cold  has  quite  disappeared, 
allow  her  only  the  dextrinized  cereals,  milk  from  which 
all  or  part  of  the  cream  has  been  removed,  fruits,  and 
vegetables.  Limit  her  butter,  and  let  her  sweets  be  only 
those  natural  sweets  found  in  the  fruit  she  eats. 


230  THE  HOME  DIETITIAN 

Measles,  Scarlet  Fever,  Influenza 

On  this  program  her  cold  will  quickly  disappear,  but 
if  her  cold  proves  to  be  the  initial  stage  of  measles, 
scarlet  fever,  or  influenza,  the  dietetic  program  instituted 
puts  her  in  the  best  possible  condition  to  combat  the 
disease.  As  the  disease  progresses,  continue  the  free 
use  of  fruit  juices  and  vegetable  broths,  and  in  addition 
to  this,  such  other  of  the  simple  foods  already  mentioned 
as  necessary  to  maintain  her  proper  nourishment. 

Her  vital  forces  being  engaged  in  combating  the  on- 
slaught of  infection,  her  food  must  all  be  such  as  will 
place  the  least  added  tax  on  her  digestive  powers.  Nec- 
essary added  nourishment  may  for  a  long  period  be 
given  in  boiled  milk,  with  or  without  the  addition  of 
zwieback  or  other  dextrinized  cereal;  or  in  the  form  of 
corn-flake  or  wheat-flake  gruel ;  or  a  combination  of  milk 
with  vegetable  puree  to  make  a  vegetable  soup.  In  ad- 
dition to  liberal  amounts  of  fruit  juice,  some  solid  fruit 
may  be  given  if  desired,  as  scraped  apple  or  soft  pear. 
It  is  very  important  that  water  be  given  in  ample 
amounts. 

Typhoid   Fever 

The  same  principle  of  feeding  applies  to  the  grown-up. 
If  some  member  of  the  family  be  so  unfortunate  as  to 
contract  typhoid  fever,  or  a  case  of  influenza  is  pro- 
longed into  the  so-called  typhoid  type,  again  we  have 
the  same  proposition  before  us,  that  of  supplying,  over 
this  protracted  period,  an  abundance  of  vitamines,  min- 
eral salts,  and  complete  proteins,  with  enough  of  other 
easily  digested  food  to  prevent  depression  of  the  vital 
forces  by  the  undue  wasting  of  the  disease. 

If  the  patient  is  to  stand  well  the  siege  of  typhoid 
fever,  he  must  be  properly  nourished,  and  again  our  diet 
list  reads:  Fruit  juices  and  vegetable  broths  freely; 
boiled  milk,  buttermilk,  vegetable  soup,  cereal  gruels, 


PRINCIPLES   OF   FEEDING   THE   SICK  231 

most  often  the  dextrinized  cereals,  as  corn-flake  and 
shredded-wheat  gruel.  So  little  being  taken  at  a  time, 
the  meals  must  be  frequent,  with  free  supply  of  fruit 
and  vegetable  juices  in  between  the  times  for  more  con- 
centrated food.  In  fevers,  meat  is  especially  difficult  of 
digestion  because  of  the  lack  in  the  stomach  of  the  nor- 
mal hydrochloric  acid  upon  which  meat  digestion  in  the 
stomach  depends.  Because  of  this  deficiency  in  the  di- 
gestive juice,  as  well  as  the  general  weakness  of  all  the 
organs,  digestion  is  necessarily  much  retarded.  The 
inhibitory  action  of  free  fat  upon  the  digestive  processes 
is  another  reason  why  free  fat  should  not  be  given 
these  patients.  (See  Chapter  VII.) 

Bilious  Attack 

Perhaps  some  member  of  the  family  has  a  digestive 
upset,  a  bilious  attack,  with  foul  breath,  coated  tongue, 
headache,  with  or  without  diarrhea.  The  alimentary 
tract  being  already  overburdened,  the  problem  of  the 
food  supply  resolves  itself  into  the  question  of  giving  the 
stomach  and  bowel  a  chance  to  clear  themselves  of  stag- 
nant material,  without  the  added  task  of  digesting  more 
food  which  could  not  well  be  utilized.  So  once  more  we 
give  our  patient  plenty  of  water,  with  fruit  juices 
freely,  limiting  his  diet  to  these  for  perhaps  twenty- 
four  or  forty-eight  hours,  when,  with  other  treatment 
directed  for  the  relief  of  the  overwhelmed  digestive 
tract,  the  symptoms  are  relieved. 


CHAPTER  XXVI 

PRINCIPLES  OF  FEEDING  THE  SICK  AS  APPLIED 
IN  CHRONIC  CONSTITUTIONAL  DISEASES 

FITCH  says  that  "  chronic  diseases  are  chiefly  the  out- 
come of  injudicious  or  pleasurable  indulgence  at  the 
table."  l  If  this  be  even  to  an  extent  true,  it  suggests 
the  thought  that  in  the  treatment  of  such  diseases  the 
dietetic  program  can  play  no  unimportant  role. 

But  how  shall  the  principles  of  feeding  be  applied  in 
chronic  disease?  This  is  often  a  great  problem,  for  the 
very  chronicity  of  the  disease  makes  it  all  the  more  im- 
portant that  the  patient  be  daily  supplied  with  all  the 
food  essentials  and  with  sufficient  calories  to  maintain 
his  strength  and  normal  weight. 

Study  the  Patient's  Diet 

The  first  thing  to  do  is  to  study  the  diet  of  the  indi- 
vidual, and  see  wherein  there  are  deficiencies.  Is  he  get- 
ting an  abundance  of  vitamines?  Does  his  daily  ration 
include  an  ample  supply  of  mineral  salts?  Is  he  getting 
enough  protein  and  of  the  proper  kind?  If  he  is  a  vic- 
tim of  a  wasting  disease,  how  much  does  his  ration  lack 
of  that  amount  necessary  to  prevent  further  wasting, 
or,  if  possible,  to  build  the  extra  tissue  needed  to  restore 
that  which  has  been  lost?  How  many  calories  is  he 
getting  daily?  And  is  he  maintaining  his  weight,  gain- 
ing in  weight,  or  continually  losing?  In  many  cases  all 
we  can  hope  to  do  is  to  keep  him  from  losing  more.  If 
he  suffers  a  progressive  loss  of  weight  that  continues 
indefinitely,  he  stands  no  chance  of  recovery  unless  the 
tide  can  be  turned  in  the  other  direction.  But  if  he  is 


"  Dietotherapy,"  Vol.  III.  p.  4. 
232 


PRINCIPLES   OF    FEEDING   THE   SICK  233 

to  recover,  at  some  time  his  diet  must  be  increased  to 
the  amount  necessary,  not  only  to  maintain,  but  grad- 
ually to  increase  his  weight. 

Weigh  the  Patient 

Whenever  possible  the  patient  should  be  weighed  at 
regular  intervals,  for  this  should  tell  us  as  much,  and 
be  as  valuable  an  aid,  as  in  the  feeding  of  infants,  where 
we  so  regularly  weigh  our  little  patients.  If,  because 
of  weak  digestion  or  other  reasons,  his  calories  must,  of 
necessity,  be  low,  let  the  deficiency  be  in  carbohydrates 
and  fats,  rather  than  too  greatly  in  proteins,  and  let  the 
diet  include  an  abundance  of  those  essential  foods  that 
make  it  possible  for  the  body  to  put  up  a  good  fight. 

In  What  Form  Should  He  Take  His  Food? 

Make  a  list  of  the  foods  which  should  be  given  him, 
including  the  food  quartet  mentioned  in  Chapter  XXV, 
and  determine  the  form  in  which  he  can  most  easily 
digest  them.  For  example,  must  his  fruits  be  limited  to 
the  juices,  or  may  he  be  allowed  the  whole  fruit?  Must 
his  vegetable  essentials  be  given  as  broths  and  purees, 
or  can  he  take  the  vegetables  themselves?  In  what 
form  will  he  most  easily  digest  cereal,  and  how  should 
he  take  his  milk  —  boiled,  skimmed,  as  whole  milk,  but- 
termilk, junket,  or  cottage  cheese?  May  he  be  allowed 
eggs  as  well? 

If  Obese  or  in  Good  Flesh 

If  the  patient  is  obese  and  may  well  afford  to  lose 
flesh,  reduce  in  carbohydrates  and  fat  calories,  remem- 
bering that  these  may  be  varied  safely,  but  beware  of 
any  great  reduction  in  his  protein  calories,  lest  his  tissue 
and  muscle  suffer  loss.  Remember  that  a  daily  protein 
ration  of  200  calories  is  a  low  protein  ration,  the  Chit- 
tenden  standard  of  200  to  300  calories,  rather  than 
the  Voit  standard  of  400  to  600  calories.  Do  not  for- 


234  THE  HOME  DIETITIAN 

get  that  much  less  than  this  minimum  of  200  calories 
cannot  safely  be  maintained  for  more  than  a  short  pe- 
riod, and  that  often  250  calories  would  be  better.  Re- 
member that  vitamines  are  needed  the  more  if  for  any 
reason  the  protein  must  be  low,  and  that  mineral  salts 
must  be  freely  supplied  to  overcome  the  often  decreased 
alkalinity  of  such  individuals. 

Two  Types 

We  have  seen  that  in  their  systemic  response  to  die- 
tetic error,  there  are  two  classes  of  individuals,  and  this 
leads  us  to  the  possibility  of  dividing  chronic  constitu- 
tional disease  into  two  great  classes.  (See  Chapters  III 
and  IV.) 

First,  the  auto-intoxication  type  includes  all  those  con- 
ditions due  to  imperfect  digestion;  second,  the  suboxi- 
dation  type,  those  conditions  in  which,  because  of  a  good 
digestion,  the  results  of  wrong  eating  are  not  felt  until 
the  food  has  left  the  digestive  tract  and  has  been  ab- 
sorbed into  the  blooi  stream.  Undoubtedly  the  two 
types  often  overlap,  and  an  extreme  condition  of  one 
type  is  impossible  without  some  of  the  conditions  typical 
of  the  other.  As  for  instance,  stagnation  in  the  diges- 
tive tract  cannot  exist  to  any  extent  without  hindrance 
to  normal  conditions  of  oxidation  and  metabolism  in  the 
tissues ;  nor  can  an  extreme  state  of  suboxidation  be 
present  without  some  degree  of  interference  with  the 
digestive  activities,  whether  in  the  stomach,  intestines, 
or  liver,  and  some  amount  of  accompanying  intestinal 
toxemia.  However,  individuals  usually  approximate 
closely  enough  to  type  to  allow  us  to  place  them,  and 
this  classification  gives  us  a  convenient  basis  for  dietetic 
treatment. 

The  First  Type 

In  the  auto-intoxication  type,  we  see  the  thin,  long- 
waisted,  dyspeptic,  catarrhal,  constipated  individual  — 


PRINCIPLES   OF   FEEDING   THE   SICK  235 

nervous,  neurasthenic,  despondent,  often  classed  as  a 
nervous  dyspeptic.  His  digestive  disturbances  are  many, 
and  he  is  afraid  to  eat,  for  everything  produces  fermen- 
tation and  distress,  and  if  perchance  he  is  able  to  eat, 
it  seems  that  the  more  he  eats,  the  thinner  he  gets. 
These  individuals  are  almost  invariably  on  a  deficient 
diet,  whether  they  eat  little  or  much.  A  careful  inves- 
tigation of  their  diet  will  undoubtedly  show  that  it  is 
deficient  in  vitamines,  deficient  in  mineral  salts,  deficient 
in  protein,  even  though,  at  times,  excessive  in  calories. 
After  a  time,  however,  their  diet  also  becomes  deficient 
in  total  calories,  because,  as  a  result  of  the  devitalized 
diet  and  condition,  the  digestive  tract  becomes  less  and 
less  able  to  do  its  work.  But  whatever  stage  these  indi- 
viduals have  reached,  the  first  thought  for  them  must 
be  to  add  to  their  diet  those  foods  that  will  supply  vita- 
mines,  mineral  salts,  and  complete  proteins. 

He  Must  Have  Fruit 

In  many  cases,  these  persons  do  not  think  they  can 
take  fruit  —  but  fruit  they  must  have.  Let  them  ven- 
ture fruit  in  the  form  of  fruit  juices  taken  an  hour  or 
half  an  hour  before  meals,  or  at  bedtime.  In  this  way 
fruit  juices  can  almost  invariably  be  taken  without  caus- 
ing trouble,  and  may  save  the  day,  even  if  fruit  cannot 
be  taken  in  any  other  form.  However,  these  patients 
will  often  find  it  possible  to  take  fruit  at  mealtime,  if 
they  take  it  alone  as  the  only  food  at  the  meal, —  for 
example,  a  fruit  breakfast  or  a  fruit  supper, —  or  if 
they  eat  it  at  the  beginning  of  the  meal  before  other 
food  has  been  taken. 

Vegetable  Broths  Have   a  Medicinal   Value 

Fruit  deficiency  can  to  an  extent  be  made  up  by  a 
free  use  of  vegetable  broths.  These  can  be  used  freely 
at  mealtime,  as  bouillon,  in  vegetable  soup,  and  can  be 
taken  as  a  drink  between  meals.  At  least  a  pint  of 


236  THE  HOME  DIETITIAN 

fruit  juice  or  of  vegetable  broth  —  better,  both  and  more 
—  should  be  taken  daily.  Fruit  juices  and  vegetable 
broths  taken  freely  will  soon  show  a  marked  beneficial 
effect  on  the  constipation  so  constant  with  this  type  of 
individual,  thus  removing  one  of  the  most  potent  fac- 
tors in  the  cause  of  his  ill  health. 

His  Protein  Ration 

Let  us  next  look  to  his  protein.  Is  he  getting  200  or 
250  calories  of  protein  daily?  These  patients  particu- 
larly need  an  ample  protein  ration,  but  often  we  hear 
them  say :  "  I  cannot  take  milk."  All  right,  let  them 
try  taking  boiled  milk,  and  great  will  be  their  surprise 
to  find  that  the  fine,  easily  digested  curds  of  boiled  milk 
cause  no  trouble,  and  the  system  soon  responds  to  the 
stimulus  of  the  protein  nourishment  for  which  they  have 
been  starved  so  long.  These  patients  have  often  been 
afraid  of  eggs.  Some  one  has  told  them  that  eggs  will 
make  them  bilious,  but  if  vitamines  are  freely  sup- 
plied, the  extra  tax  of  digesting  an  egg  or  two  daily 
will  usually  be  well  borne,  especially  as  they  supply  much- 
needed  protein.  The  yolk  of  the  egg  also  supplies  iron 
and  a  goodly  amount  of  vitamine.  Cottage  cheese,  an 
excellent  protein  food,  is  usually  well  borne  by  every 
one.  It  may  be  served  plain  or  with  cream  or  as  cottage 
cheese  omelet.  (See  recipe  48.)  Buttermilk  is  valuable, 
and  if  taken  with  a  spoon  instead  of  being  drunk  as  an 
ordinary  liquid,  it  usually  will  cause  no  trouble.  Vege- 
table soups,  made  from  recipes  in  Chapter  XXXI,  are 
valuable  protein  additions,  and  the  more  tender  leafy 
vegetables,  as  cauliflower,  spinach,  etc.,  can  be  taken, 
with  their  protein,  mineral,  and  vitamine  value.  Refer- 
ence to  calorie  tables  (se"e  Appendix)  makes  compara- 
tively easy  the  calculation  of  the  amount  of  protein 
taken,  which,  as  has  been  said,  should  be  not  less  than 
200  calories;  more,  in  many  cases,  would  be  better. 


PRINCIPLES   OF   FEEDING   THE   SICK  237 

How  to  Gain  in  Weight 

The  vitamines,  mineral  salts,  and  proteins  being  sup- 
plied, the  question  of  calories  must  next  be  considered. 
The  thin  individual  needs  more  than  enough  to  maintain 
his  weight  and  strength  if  he  is  to  gain  flesh,  but  he 
will  do  well  for  a  time  to  content  himself  with  a  main- 
tenance ration  until  his  digestive  organs,  under  the  new 
regime,  have  attained  greater  strength  and  his  system 
is  free  from  all  accumulated  wastes.  By  watching  his 
calories  daily  and  the  scales  weekly  or  biweekly,  it  is 
possible  to  find  the  maintenance  diet.  How  little  can  he 
eat  and  not  lose? 

After  a  short  time,  to  his  maintenance  diet  may  be 
carefully  added  extra  calories  in  the  way  of  such  concen- 
trated foods  as  olives,  dates,  prunes,  nuts  well  masti- 
cated. Begin  perhaps  with  six  olives  three  times  daily, 
or  three  dates  and  three  almonds  at  each  meal;  or 
prunes  for  breakfast,  almonds  for  dinner,  dates  for  sup- 
per, in  addition  to  his  previous  regular  dietary  schedule. 

Cereals  in  various  forms  help  to  make  up  necessary 
calories  and,  if  whole  cereals,  they  supply  some  mineral 
salts  and  a  limited  amount  of  vitamines  as  well,  and 
should  be  taken  as  hard  toast,  dextrinized  cereals,  and 
gruels.  Browned  rice  (see  recipe  21)  is  easily  digested. 

In  the  initial  dietary  treatment,  these  patients  gain 
nothing  by  eating  cream,  butter,  and  olive  oil.  These 
foods  often  hinder  the  digestion  to  the  extent  that  the 
patient  does  not  get  the  full  benefit  of  any  of  the  food 
he  eats.  Later,  however,  cream  may  be  taken  by  some, 
and  if  well  borne,  is  a  valuable  means  of  adding  cal- 
ories in  concentrated  form.  It  can  very  easily,  however, 
be  overdone;  and  at  all  times,  butter  and  oils  should  be 
used  very  sparingly,  as  they  are  ever  a  hindrance  to 
digestion,  and  tend  to  increase  the  general  catarrhal 
conditions  to  which  these  individuals  are  often  suscep- 
tible. (See  page  52.) 


238  THE  HOME  DIETITIAN 

In  checking  up,  let  the  patient  note  whether  or  not 
his  diet  includes  each  of  the  four  kinds  of  foods  men- 
tioned as  the  important  quartet  in  Chapter  XXV.  He 
must  be  getting  fruits,  either  as  fruit  juices  or  as  fruits 
eaten  alone,  or  at  the  first  of  the  meal;  vegetables,  as 
broths,  soups,  leafy  vegetables,  including,  if  possible, 
some  raw  vegetable  daily.  He  must  be  getting  milk  or 
other  dairy  product,  as  boiled  milk,  buttermilk,  cottage 
cheese,  or  eggs;  and  cereals,  as  oven  toast,  gruels,  stale 
bread,  rarely  mushes. 

It  is  quite  possible  for  his  diet  to  include  all  of  the 
above  foods  in  some  of  their  forms,  and  if  they  are  in- 
cluded, and  if  the  proportion  of  fruits  and  fruit  juices, 
vegetables  and  vegetable  broths,  is  ample,  his  diet  is 
complete  and  he  has  taken  a  great  step  toward  the  sur- 
mounting of  his  physical  difficulties.  And  let  him  re- 
member that,  whatever  he  eats,  he  must  chew,  chew, 
chew. 

To  summarize  then :  The  point  is,  for  this  thin  dys- 
peptic to  have  supplied  to  him  freely  the  essential  foods; 
find  his  maintenance  diet  as  to  calories,  and  after  two 
or  three  weeks,  gradually  push  his  calories  beyond  his 
maintenance  diet  until  he  gains  in  weight.  But  let  him 
remember  that  often  a  decrease  in  diet,  with  a  cutting 
out  of  his  excess  of  butter,  must  come  before  it  will  be 
possible  for  him  to  add  to  his  diet  the  extra  calories 
necessary  for  him  to  gain  his  desired  weight. 

An  initial  loss  of  a  pound  or  two  during  the  first 
week  may  be  an  advantage.  It  is  often  a  help  in  finding 
the  maintenance  diet,  and  can  soon  be  followed  by  a 
satisfatcory  gain. 

Gastric  Ulcer 

Cases  of  gastric  ulcer  usually  occur  in  persons  of 
this  type,  and  with  a  few  modifications,  the  feeding 
principles  are  the  same.  With  these  the  condition  of 
irritation  in  the  stomach  has  progressed  to  the  extent 


PRINCIPLES   OF   FEEDING   THE   SICK  239 

that  the  mucous  membrane  has  become  abraded,  and 
an  ulcer  has  formed.  All  food  taken,  then,  must  be 
in  a  bland,  demulcent  form,  which  will  soothe  rather 
than  increase  the  irritation.  Accordingly,  those  usually 
best  taken  are  cereal  gruels  from  which  all  cellulose  has 
been  removed,  boiled  milk,  cream,  soft  eggs,  with  de- 
pendence upon  vegetable  broths  rather  than  upon  fruit 
juices  for  vitamines  and  salts.  Vegetable  broths  should 
be  given  freely.  Later,  vegetable  purees,  baked  potato, 
subacid  fruits,  and  fruit  juices.  Fruit  juices  may  in 
many  cases  be  allowed,  carefully,  from  the  first.  It 
should  ever  be  remembered  that  the  proper  nourishment 
of  the  individual  is  an  important  factor  in  the  produc- 
tion of  a  cure. 

Constipation 

Constipation  being  so  characteristic  of  this  type  of 
individual,  we  cannot  forbear  giving  it  a  word  in  pass- 
ing, though  it  would  be  impossible  for  us  to  dwell  at 
length  upon  a  subject  about  which  so  much  might  be 
said.  However,  this  we  will  say:  If  an  individual's 
daily  ration  is  well  balanced,  containing  a  sufficient 
amount  of  vitamines  in  the  way  of  fresh  fruits  and  veg- 
etables, and  it  he  does  not  overeat,  he  seldom  needs  to 
be  troubled  with  constipation.  Overeating  is  often  a 
cause  of  constipation.  Constipation  is  a  phase  of  intes- 
tinal indigestion,  and  is  often  due  primarily  to  the  pack- 
ing of  the  intestinal  tract  with  an  excessive  amount  of 
concentrated  food,  making  it  impossible  for  the  muscula- 
ture of  the  intestinal  wall  to  properly  do  its  work  in  mix- 
ing the  food  and  passing  it  on  in  a  normal  length  of 
time.  If  the  bowel  is  not  crowded  with  too  concentrated 
a  mass  of  food,  there  need  be  no  resulting  constipation. 
Cellulose  is  helpful  in  that  it  gives  bulk  that  is  light 
and  without  concentration,  and  the  gentle  stimuli  of  the 
vitamine  foods  are  also  needed  to  insure  normal  peris- 
taltic activity. 


240  THE  HOME  DIETITIAN 

A  free  amount  of  fruit  in  the  daily  diet  may  be  con- 
sidered absolutely  essential  to  good  bowel  drainage, 
(See  Chapter  XL)  If,  after  planning  a  carefully  bal- 
anced ration  which  furnishes  proper  nourishment  and 
does  not  overcrowd  the  digestive  tract,  the  individual  is 
constipated,  it  usually  means  that  he  needs  more  fresh 
fruit.  A  glass  or  two  of  fruit  juice,  orange  juice  rank- 
ing first,  between  meals  or  at  bedtime,  in  addition  to  a 
free  amount  of  fruit  taken  with  at  least  one  meal  of 
the  day,  will  usually  solve  the  difficulty. 

Some  Foods  Too  Irritating 

The  cellulose  of  fruit  and  vegetables  and  whole-wheat 
bread  is  usually  sufficient  without  bran,  so  commonly 
used,  which  in  many  cases  is  irritating  to  the  sensitive 
mucous  lining  of  the  digestive  tract.  In  cases  of  long- 
standing constipation  resulting  in  a  s.ore,  irritable,  and 
oftentimes  contracted  bowel,  the  stagnant  condition  can 
best  be  combated  by  a  bland  diet,  complete  as  to  food 
essentials,  but  with  a  minimum  of  the  coarser,  more 
irritating  foods,  such  as  vegetable  cellulose  and  even 
fruit  fiber.  In  some  of  these  cases  the  laxative  effect  of 
fruit  juices  must  be  relied  upon,  the  cellulose  of  the 
fruit  not  being  well  borne  at  first,  but  added  a  little 
later.  Vegetable  broths,  soups,  purees,  and  the  more 
tender  vegetables  may  be  used,  eschewing  the  coarser 
variety.  These  cases  are  only  made  worse  by  anything 
producing  an  irritating  effect,  as  bran,  or  even  the 
mild  laxatives. 

Boiled  milk,  contrary  to  the  popular  opinion,  is  not 
constipating,  but  in  long-standing  cases  of  constipation 
it  is  much  less  liable  to  cause  intestinal  indigestion  than 
raw  milk.  (See  page  267.)  Whole-grain  cereals  are 
more  laxative  in  their  effect  than  the  refined  variety, 
and  whether  these  should  be  taken  as  mushes,  gruels, 
bread,  or  oven  toast,  depends  upon  the  individual. 


PRINCIPLES   OP   FEEDING   THE   SICK  241 

Too  Much  Cereal 

It  should  be  remembered  that  a  preponderance  of  any 
cereal  in  the  diet  tends  to  constipation  because  of  an 
excess  of  concentrated  food,  and  that  the  lighter  dex- 
tiinized  cereals  move  with  greater  ease  through  the  di- 
gestive canal.  It  is  also  important  to  know  that  in  cases 
of  irritable  contracted  bowel,  whether  simply  the  ca- 
tarrhal  stage  of  chronic  constipation  or  the  more  extreme 
condition  known  as  mucous  colitis,  gruels,  because  of 
their  bland,  demulcent  action,  are  much  to  be  preferred 
to  mushes.  Gruels  should  always  be  eaten  slowly,  pref- 
erably with  hard  toast.  Prunes,  dates,  and  figs  have  a 
mild  laxative  action. 

It  is  needless  to  say  that  tea,  coffee,  condiments,  and 
spices  should  be  avoided. 

Respiration  Troubles 

A  tendency  to  catarrh,  frequent  colds,  bronchitis,  etc., 
in  both  old  and  young,  may  be  greatly  relieved  if  not 
ent'iely  cured,  by  careful  attention  to  the  diet  as  out- 
I'ned  for  the  auto-intoxication  type  of  individual.  Vita- 
mines  and  other  necessary  food  elements  being  freely 
supplied,  excess  of  fats  and  sugars  being  eliminated,  and 
constipation  being  overcome,  the  individual  will  often  be 
surprised  at  the  marked  relief  from  annoying  symptoms 
refeiable  to  the  respiratory  as  well  as  to  the  digestive 
tract. 

Skin  Affections 

While  many  factors  enter  into  the  cause  of  skin  affec- 
tions, yet  the  one  afflicted  with  eczema,  acne,  boils,  etc., 
will  do  well  to  include  as  a  part  of  his  treatment,  atten- 
t:on  to  his  diet,  with  special  reference  to  suggestions  as 
outlined  above.  The  elimination,  for  a  time  at  least,  of 
all  free  fat,  as  butter,  oils,  etc.,  with  the  minimum 
amount  of  cream,  will  often  have  a  most  beneficial  ef- 

16 


242  THE  HOME  DIETITIAN 

feet,  especially  if,  at  the  same  time,  an  abundance  of 
vitamine  foods  is  supplied,  and  protein  is  taken  in  the 
form  least  liable  to  cause  intestinal  putrefaction,  as 
boiled  milk,  buttermilk,  or  cottage  cheese. 

Other   Toxic  Diseases 

There  may  be  placed  in  this  class,  as  extreme  results 
of  auto-intoxication,  or  intestinal  toxemia,  such  diseases 
as  pernicious  anemia,  and  the  toxic  form  of  arthritis 
deformans,  a  chronic  disease  of  the  joints,  causing  great 
deformity.  There  is  much  to  make  it  seem  that  these 
conditions  have,  to  an  extent  at  least,  their  foundation 
in  absorption  of  poisons  from  the  intestinal  tract,  and 
their  dietetic  treatment  should  be  carried  out  along  the 
lines  already  suggested  for  the  auto-intoxication  type. 
The  great  point  is  to  prevent  intestinal  putrefaction  and 
at  the  same  time  to  nourish  the  patient. 

In  order  to  prevent  putrefactive  processes,  it  may  be 
necessary  to  restrict  the  diet  to  the  minimum  necessary 
to  maintain  the  patient,  at  the  same  time  pushing  the 
vitamine  content  of  the  food.  Here  fruit  juices  and 
vegetable  broths,  spinach  broth,  etc.,  have  their  greatest 
efficacy  and  should  be  used  freely.  As  an  initial  treat- 
ment, a  diet  limited  for  a  few  days  to  vegetable  broths 
and  fruit  juices  given  at  intervals  of  one  to  two  hours, 
will  work  like  magic  in  some  cases.  It  is  usually  impor- 
tant to  omit  animal  protein  from  the  diet,  except  that 
as  given  in  boiled  milk,  buttermilk,  or  cottage  cheese. 

In  exophthalmic  goiter,  a  disease  not  well  understood, 
but  one  in  which  the  thyroid  gland,  with  its  tonic  effect 
on  the  nervous  system,  seems  to  work  overtime,  thus 
producing  abnormal  stimulation,  with  rapid  heart, 
tremor,  often  diarrhea,  etc.,  the  question  of  feeding  re- 
solves itself  into  one  of  a  diet  that  furnishes  an  ample 


PRINCIPLES   OF   FEEDING   THE   SICK  243 

amount  of  vitamines  and  salts,  with  necessary  amount 
of  protein,  but  at  the  same  time  includes  nothing  which 
could,  in  any  way,  because  of  errors  in  digestion  or 
metabolism,  contribute  to  the  irritable  state  of  the  thy- 
roid gland.  Whether  or  not  there  be,  in  any  individual 
case,  direct  connection  between  the  diet  and  this  disease, 
every  effort  should  be  made  to  let  the  dietary  part  of 
the  daily  program  be  conducive  to  the  highest  type  of 
body  existence  and  equilibrium. 

Experience  tells  us  that,  many  times,  intestinal  con- 
ditions are  at  least  one  factor  in  the  production  of  thy- 
roid irritation,  and  often  an  accompanying  diarrhea 
denotes  a  participation  of  the  alimentary  tract  in  the 
general  instability.  Therefore,  no  added  or  undue  strain 
should  be  placed  upon  the  digestion.  Intestinal  putre- 
faction should  be  assiduously  avoided  even,  if  necessary, 
to  the  prohibition  of  all  animal  protein  and  the  sim- 
plicity of  an  antitoxic  diet  rich  in  vitamine-containing 
foods. 

The  individual  will  need  to  eat  according  to  his  type, 
whether  that  just  considered  above  or  the  one  outlined 
below.  If  he  is  of  the  auto-intoxication  type,  as  he 
often  is,  he  must  eat  to  overcome  his  digestive  short- 
comings. If  of  the  suboxidation  type,  to  increase  his 
oxidation  processes.  Digestive  abnormalities  and  meta- 
bolic disturbances  should  be  corrected  by  dietetic  treat- 
ment, as  outlined  in  this  chapter,  in  so  far  as  this  is 
possible.  Many  times  on  the  proper  dietetic  regime  the 
results  are  very  gratifying,  and  often  helpful,  in  ob- 
taining desired  effects  from  other  therapeutic  measures. 

Exophthalmic  goiter  may  be  taken  as  a  type  of  a  class 
of  diseases  apparently  due  to  a  disturbance  in  the  endo- 
crine balance,  i.  e.,  the  mechanism,  whereby,  as  the  re- 
sult of  a  harmonious  interaction  of  the  ductless  glands 
(the  thyroid,  suprarenals,  ovaries,  etc.)  the  sympathetic 


244  THE  HOME  DIETITIAN 

nervous  system  is  controlled  in  all  its  activities.  In  all 
conditions  of  this  class,  dietetic  treatment  may  be  a  help 
in  tending  to  correct  associated  digestive  and  metabolic 
disturbances,  whether  causal  or  resultant,  that  if  left 
uncorrected  might  stand  in  the  way  of  the  patient's  sat- 
isfactory progress  and  ultimate  recovery. 

The   Second   Type 

The  suboxidation  type  of  person  has  no  trouble  with 
digestion.  For  that  reason  he  has  not  the  disturbing 
symptoms  of  the  dyspeptic  to  place  a  check  upon  his 
gastronomic  indulgences,  and  the  results  of  his  dietetic 
errors  are  often  not  felt  till  long  after  the  harm  has 
been  done.  In  this  class  come  those  conditions  due  to 
accumulated  wastes  in  the  blood  and  the  tissues  because 
of  imperfect  metabolism  and  elimination  (see  Chapter 
IV)  ;  for  example,  gout,  rheumatism,  so  called,  high  blood 
pressure,  hardening  of  the  arteries,  obesity,  fatty  heart, 
and  Bright's  disease.  These  persons  have  a  good  appe- 
tite, can  eat  anything,  are  usually  fond  of  sweets,  butter, 
rich  foods,  etc.,  and  see  no  connection  between  their 
symptoms  and  their  dietetic  habits. 

These  individuals  need,  with  all  others,  the  dietary  es- 
sentials; they  need,  first  of  all,  vitamines  to  stimulate 
processes  of  metabolism  and  oxidation.  They  need  min- 
eral salts  to  increase  the  alkalinity  of  the  blood;  they 
need  protein  to  make  muscle,  for  the  excess  of  tissue 
that  they  often  have  is  not  muscle,  but  fat,  and  the 
muscle  that  they  do  have  is  not  of  a  good  quality. 

To  Reduce  in  Weight 

To  decrease  the  protein  part  of  their  dietary  much 
below  normal  limits  is  a  mistake,  but  of  total  calories 
they  can  well  bear  a  marked  reduction  with  only  benefit. 
Their  tissues  are  so  often  clogged  with  uneliminated 
wastes  that  a  low  ration  for  a  time  is  very  necessary 


PRINCIPLES   OF   FEEDING   THE   SICK  245 

for  the  best  results,  but  this  decrease  should  be  in  car- 
bohydrates and  fats,  not  to  any  extent  in  protein,  unless, 
of  course,  the  protein  intake  has  been  excessive.  If 
overweight,  they  can  use  to  good  advantage  the  energy 
food  already  stored  in  their  own  tissues  as  fat.  In  this 
way  the  system  may  free  itself  from  the  handicap  of 
excess  tissue  and  burn  up  to  better  advantage  other 
accumulated  wastes. 

These  patients,  with  all  others,  need  fruits  and  fruit 
juices,  but  when  seeking  to  reduce  in  calories  for  the 
purpose  of  losing  in  weight,  the  vegetable  juices  and 
broths  may  be  used  more  freely,  and  the  fruits  that 
are  not  so  high  in  caloric  value.  The  juice  of  a  lemon 
twice  daily  in  water,  or  a  grapefruit,  or  an  orange. or 
two  for  breakfast,  may  be  sufficient,  if  vegetable  broths 
are  taken  freely  as  well  as  green  and  leafy  vegetables. 
Tomatoes  are  of  especial  value  in  these  cases,  because, 
while  their  vitamine  content  is  high  and  they  are  rich 
in  alkalizing  salts,  they  are  low  in  calories.  The  acid- 
ity of  the  tomato  seems  to  stabilize  the  vitamine  so  that 
it  is  not  destroyed  even  in  the  process  of  canning.  It 
has  been  shown  that  canned  tomatoes  can  be  made,  in 
a  great  measure,  to  take  the  place  of  orange  juice. 

Low  in  Caloric  Value 

Lettuce,  celery,  cauliflower,  cabbage,  raw  or  cooked, 
raw  carrots,  string  beans,  asparagus,  spinach,  and  other 
greens  should  be  used  freely.  Turnips  are  also  good,  in 
that  they  are  low  in  caloric  value.  All  vegetables  should 
be  cooked  down  in  their  own  broth  and  served  without 
fatty  seasoning.  Protein  can  be  supplied,  without  fur- 
nishing an  excess  of  calories,  in  the  form  of  skim  milk, 
buttermilk,  cottage  cheese,  or  an  egg  or  two  daily. 

How  Many  Calories? 

The  last  question  is,  How  many  calories  does  the  pa- 
tient need?  If  his  weight -is  normal,  he  pe^s  simply 


246  THE  HOME  DIETITIAN 

enough  to  maintain  that  weight,  and  no  more.  He 
should  watch  the  scales  until  he  loses,  say  half  a  pound. 
Then  it  is  evident  that  the  margin  is  reached,  and  it  will 
be  a  simple  matter  for  him  to  make  the  slight  caloric 
adjustment  to  prevent  greater  loss.  But  if  the  loss  of 
a  few  pounds  is  desirable,  his  daily  calories  can  be  less- 
ened accordingly,  perhaps  200  or  300  calories  a  day  less 
than  necessary  for  maintenance,  with  practically  no  dis- 
comfort, providing  his  proteins,  vitamines,  and  salts  are 
sufficient.  After  a  time  his  ration  may  be  increased, 
but  he  should  avoid  putting  on  flesh  that  he  does  not 
need.  Because  of  the  concentration  of  sugar,  fats,  and 
pastries,  he  will  find  it  necessary  to  deny  himself  largely 
of  these.  The  olives,  nuts,  dates,  and  cream,  etc.,  al- 
lowed the  thin  individual  cannot,  of  course,  be  added 
ordinarily  to  the  diet  list  of  the  one  who  is  overweight. 
Increased  strength,  vigor,  and  happiness,  as  well,  will 
be  his  reward  for  abstemiousness.  (See  page  31.) 

To  Reduce  Blood  Pressure 

On  the  above  regime  it  has  become,  in  the  author's 
experience,  a  very  easy  matter,  not  only  to  reduce  in  a 
most  satisfactory  way  the  weight  of  obese  individuals, 
but  also,  in  conditions  of  high  blood  pressure,  to  lower 
the  blood  pressure  30  to  60  points  in  often  as  short  a 
period  as  ten  days.  In  this  way,  a  sphygmomanometer 
reading  may  be  changed  from  200  or  more  to  160  or  be- 
low; and  invariably  there  has  accompanied  the  loss  of 
weight,  or  the  relief  from  excessive  arterial  pressure, 
a  marked  relief  from  other  symptoms,  with  an  added 
sense  of  well-being  on  the  patient's  part.  Exceptions  to 
the  above  would  be  cases  with  a  marked  degree  of 
arteriosclerosis  or  kidney  involvement.  However,  even 
these  show  decided  benefit. 

In  the  dietetic  treatment  of  heart  and  kidney  disease, 
the  principles  are  the  same,  modified  in  these  conditions 


PRINCIPLES   OF   FEEDING   THE   SICK  247 

by  the  consequently  weakened  state  of  the  digestive  or- 
gans. In  these  cases  it  is  necessary  for  us  to  go  back 
to  our  principles  of  feeding  in  acute  illnesses,  giving  all 
the  food  essentials  in  the  most  easily  digested  form,  "less- 
ening the  number  of  calories,  because  of  the  enforced 
inactivity  of  the  patient. 

Salt-free  Diet 

It  is  particularly  necessary  in  kidney  disease  to  avoid 
all  condiments,  even  salt  except  in  very  moderate 
amounts,  because  of  the  irritating  effect  upon  the  kid- 
neys in  the  process  of  their  elimination.  A  salt-free  diet 
has  long  been  recognized  as  the  logical  part  of  the 
treatment  of  Bright's  disease.  Recent  literature  on  the 
subject,  questions  the  necessity  for  such  absolute  re- 
striction, but  all  are  agreed  that  the  amount  of  salt  in- 
gested should  be  limited  to  body  need,  which,  according 
to  Sherman,  would  be  about  one  fourth  the  amount  usu- 
ally taken.  We  are  reminded  by  this  of  the  importance 
of  a  normal  diet  both  in  the  prevention  and  in  the  cure 
of  disease,  and  the  diet  most  surely  curative  in  any  dis- 
ease is  the  one  that  most  completely  supplies  body  need 
with  the  least  strain  on  those  tissues  already  weakened 
by  digestive  and  metabolic  shortenings. 

Diabetes 

Diabetes  is  a  chronic  constitutional  disease,  due  to  the 
inability  of  the  tissue  to  metabolize  carbohydrates.  For 
convenience,  it  may  be  classed  with  those  of  the  suboxi- 
dation  type.  In  it  there  is  a  condition  of  defective  analy- 
sis of  the  carbohydrate  part  of  the  food.  (See  Chap- 
ter IV.)  The  tissues  are  unable  for  some  reason  to 
oxidize  sugar.  Therefore,  the  blood,  not  being  able  to 
utilize  the  ingested  carbohydrate,  treats  it  as  a  foreign 
substance,  and  as  such,  eliminates  it  in  the  urine.  The 
disease  is  not  one  of  the  kidneys,  but  is  one  of  metabo- 


248  THE  HOME  DIETITIAN 

lism.  If  the  blood  is  unable  to  metabolize  and  to  use 
carbohydrates,  there  can  be  no  possible  advantage  in 
eating  them,  as  food  not  used  by  the  body  only  imposes 
a  biirden  and  thus  does  harm. 

Eat  Only   That  Which   the   Body   Can  Use 

What  purpose  do  carbohydrates  serve  in  the  diet? 
Principally  that  of  supplying  calories  in  an  easily  oxi- 
dized form ;  they  supply  neither  vitamines,  mineral  salts, 
nor  proteins,  except  as  they  are  taken  in  combination 
with  these.  In  feeding  a  diabetic  patient,  then,  the 
principle  is  this:  In  the  early  treatment  feed  him  vita- 
mines,  mineral  salts,  and  proteins,  unassociated  as  nearly 
as  possible  with  carbohydrates.  Supply  calories  in  the 
form  of  protein  or  fat.  As  the  patient's  ability  to  me- 
tabolize carbohydrates  improves  under  proper  diet  and 
care,  add  carefully  small  amounts  of  carbohydrates  until 
an  examination  of  the  urine  shows  that  they  are  not 
being  utilized,  but  are  being  eliminated  as  sugar.  Then 
withdraw  carefully  until  sugar  no  longer  appears  in  the 
urine. 

Fat  as  a  Cause  of  Diabetic  Acidosis 

The  great  problem  in  feeding  these  patients  is  in  sup- 
plying the  necessary  caloric  food  value,  as,  normally, 
the  great  bulk  of  calories  is  supplied  by  the  carbohy- 
drate part  of  the  diet.  The  patient's  chance  of  over- 
coming his  disease  lies  in  there  being  supplied  to  him 
freely  his  vitamines  and  mineral  salts  with  necessary 
amount  of  protein  food.  To  this  there  may  be  added  a 
varying  amount  as  regards  caloric  food  value.  His  fat 
had  better  be  supplied  to  him  in  a  combined  form,  as 
in  olives  and  nuts,  rather  than  as  an  excess  of  free 
fats.  The  mistake  has  often  been  made  of  pushing  the 
fats  to  too  great  an  extent.  This  may  easily  overtax 
the  body's  ability  to  metabolize  fats  and  cause  an  accu- 


PRINCIPLES   OF   FEEDING   THE   SICK  249 

mulation  in  the  blood  of  the  products  of  incomplete  fat 
metabolism,  and  is  thought  by  some  to  be  a  factor 
in  the  causation  of  the  state  of  lessened  alkalinity  so 
common  with  these  patients  and  often  referred  to  as 
diabetic  acidosis. 

Carbohydrate,  as  we  have  seen,  is,  under  normal  con- 
ditions, more  easily  oxidized  than  fat.  Attention  has 
already  been  called  to  the  fact  that  carbohydrate  has 
been  likened  to  "  the  kindling,"  the  combustion  of  which 
accelerates  the  oxidation  of  fat,  the  more  concentrated 
fuel.  When  the  normal  utilization  of  the  carbohydrate 
becomes  impossible,  great  care  must  be  taken  that  the 
body  is  not  swamped  with  fat  that  it  cannot  metabolize. 
Less  harm  will  be  done,  in  many  cases,  by  venturing, 
gradually,  a  little  more  carbohydrate  in  combination 
with  vitamines,  as  in  fruit  juices;  or  in  combination 
with  complete  proteins,  as  in  boiled  milk,  than  in  too 
greatly  pushing  the  fat,  especially  in  its  concentrated, 
uncombined  form.  To  combat  the  tendency  toward  aci- 
dosis, a  goodly  supply  of  mineral  salts  may  be  given, 
and  these  best  in  leafy  vegetables  or  their  broths. 
These,  as  we  know,  also  supply  vitamines  and  complete 
proteins. 

It  is  quite  as  necessary  that  the  diabetic  have  fur- 
nished to  him  food  essentials  as  it  is  that  any  other 
patient  have  them,  and  his  recovery  can  never  be  hoped 
for  unless  his  dietary  program  very  soon  allows  him 
these  foods.  Very  good  results  may  often  be  obtained 
by  placing  the  patient,  for  a  few  days,  on  a  diet  of 
vegetable  broth.  He  should  be  put  to  bed  and  vegetable 
broths  given  him  freely,  say  eight  ounces  every  one  or 
two  hours.  These  may  be  prepared  according  to  recipes 
in  Chapter  XXXI,  and,  preferably,  they  should  be  made 
from  the  leafy  vegetables.  He  may  take  the  water  from 
spinach,  cauliflower,  or  other  leafy  vegetable  singly  or 


250  THE  HOME  DIETITIAN 

in  combination.  The  urine  in  most  cases  will  become 
sugar  free  in  a  few  days;  then  other  foods  may  be 
added.  The  additional  foods  should  be  those  supplying 
the  least  amount  of  carbohydrate,  but  rich  in  the  essen- 
tial food  elements. 

Noncarbohydrate   Foods 

The  foods  containing  the  smallest  amount  of  carbo- 
hydrate are  the  leafy  vegetables,  as  lettuce,  spinach, 
greens  of  various  kinds,  asparagus,  cabbage,  Brussels 
sprouts,  etc.,  also  string  beans,  celery,  artichokes,  toma- 
toes, and  cucumbers.  Of  the  fruits,  lemon,  grapefruit, 
and  olives  are  among  the  lowest.  Those  foods  contain- 
ing a  little  more  carbohydrate,  but  still  low,  are  turnips, 
carrots,  sq'uash,  onions;  the  more  acid  fruits,  as  oranges, 
cranberries,  gooseberries,  etc. ;  nuts  of  various  kinds,  the 
Brazil  nut,  the  pecan,  and  the  filbert  being  slightly 
lower  than  the  English  walnut.  After  these,  still  higher 
in  the  scale  are  green  peas,  green  Lima  beans,  parsnips, 
pears,  apples,  huckleberries,  apricots,  peaches,  currants. 
Those  highest  in  carbohydrate  are  potatoes,  bread,  ce- 
reals, legumes,  macaroni,  spaghetti,  and  sweet  fruits,  as 
prunes,  bananas;  also  peanuts  and  chestnuts. 

In  the  most  severe  cases  the  balance  lies  between  the 
question  of  the  patient's  succumbing  to  inanition  or  a 
giving  up  of  the  attempt  to  make  the  urine  sugar  free. 
Some  patients  will  stand  a  better  chance  of  recovery 
on  a  fuller  ration,  even  though  sugar  is  not  entirely 
eliminated  from  the  urine. 

The  following  menus  are  suggestive  as  to  possible 
food  combinations.  To  these,  in  many  cases,  may  be 
added  gradually  a  fuller  ration,  watching  the  urine  for 
any  evidence  that  the  body  is  unable  to  utilize  the  added 
carbohydrates. 


PRINCIPLES   OF   FEEDING   THE   SICK  251 

Suggestive  Menus  for  the  Diabetic 

No.   1  Protein  Carbohydrate     Total 

BREAKFAST  Calories        Calories        Calories 

Whole  Grapefruit   (without  sugar)    7  89  100 

Soft  Eggs    (2)     50  ..  150 

Almonds    (6)     15  3  100 

Per  cent  of  protein  for  the  meal,  21.  72  92  350 

Per  cent  of  carbohydrate  for  the  meal,  27. 

Note  that  the  per  cent  of  protein  is  very  high  com- 
pared to  the  average  per  cent  of  the  ordinary  meal. 
(See  page  163.)  This  may  well  be  so,  however,  be- 
cause of  the  very  low  total.  The  per  cent  of  carbohy- 
drate in  the  average  meal  is  about  80  per  cent,  making 
it  evident  that  the  above  percentage  of  27  is  very  low. 
The  calories  of  fat  are  not  given  here;  if  desired,  they 
can  easily  be  found  by  subtracting  from  the  total  the 
sum  of  the  protein  and  carbohydrate  calories. 

10:  30  A.  M. 

Vegetable  Broth  (8  oz.) 

This  vegetable  broth  may  be  made  according  to  any 
recipes  given  in  Chapter  XXXI,  except  that  any  bean 
broth  should  be  omitted. 

Protein  Carbohydrate     Total 
DINNER  Calories        Calories        Calories 

Tomato   Gluten   Soup    23  74  103 

Lettuce  Hearts  with  French  Dressing   3  6  50 

Asparagus    (12    stalks)    12  21 

Olives     (8) 8  16  160 

Egg  Yolks   (2)    16  100 

Per  cent  of  protein  for  the  meal,  11.  62  117  451 

Per  cent  of  carbohydrate  for  the  meal,  25. 

4:  00  P.  M. 

Vegetable  Broth. 

Protein  Carbohydrate    Total 
SUPPEB  Calories        Calories        Calories 

Vegetable    Broth    35  48 

Cottage  Cheese  with  Cream    50  16  160 

Olives    (8)      8  16  160 


252  THE  HOME  DIETITIAN 

Brazil   Nuts    (2)     7  3  70 

Per  cent  of  protein  for  the  meal,  20.  100  83  490 

Per  cent  of  carbohydrate  for  the  meal,  18. 

BEDTIME 

Vegetable  Broth  (8  oz.) 

The  total  calories  for  the  day,  exclusive  of  the  vege- 
table broth  between  meals,  which  in  some  cases  may  be 
omitted,  equals  1,291  calories.  The  extra  vegetable 
broth  will  give  from  150  to  300  calories  more,  depend- 
ing upon  its  preparation  and  the  amount  taken.  This 
would  make  possible  1,591  calories,  with  339  calories  of 
protein.  It  supplies  a  large  amount  of  vitamines  and 
salts  with  the  least  amount  of  carbohydrate.  In  severe 
cases,  even  the  amount  of  carbohydrate  allowed  in  this 
daily  ration  might  need  to  be  decreased,  which  could  be 
done  by  lessening  those  foods  furnishing  the  largest 
proportion  of  carbohydrates.  However,  care  should  be 
taken  that  the  vitamine  foods  are  not  greatly  decreased. 

No.   2  Protein  Carbohydrate     Total 

BREAKFAST  Calories        Calories        Calories 

Fresh  Tomatoes    (2)    14  48  66 

Scrambled  Eggs   (equivalent  to  2  eggs)    ...   50  ..  175 

Walnuts     (3)     10  8  100 

Per  cent  of  protein  for  the  meal,  22.  74  5^  341 

Per  cent  of  carbohydrate  for  the  meal,  17. 

Protein  Carbohydrate     Total 
DINNEB  Calories        Calories        Calories 

Vegetarian    Consomme    36  25  65 

Graham  Zwieback   (1  small  slice)    10  60  75 

Lettuce  Hearts  with  French  Dressing   3  6  50 

String  Beans   (large  serving)     10  12  25 

Olives    (8)              8  16  160 


Per  cent  of  protein  for  the  meal,  18.  67  119  375 

Per  cent  of  carbohydrates  for  the  meal,  36. 

4:  00  P.  M. 

Vegetable  Broth. 


PRINCIPLES   OF   FEEDING   THE   SICK  253 

Protein  Carbohydrate     Total 
SUPPER  Calories        Calories        Calories 

Vegetable    Broth     35  48  100 

Carrot  and  Cottage  Cheese  Salad   69  21  170 

Olives    (8)      8  16  160 

Per  cent  of  protein  for  the  meal,  26.  112  85  430 

Per  cent  of  carbohydrate  for  the  meal,  20. 

In  preparing  the  salad,  use  2  heaping  tablespoons 
cottage  cheese,  1  heaping  tablespoon  carrots,  and  six 
almonds,  then  add  a  lemon  dressing. 

BEDTI M  K 

Vegetable  Broth. 

The  total  calories  for  the  three  meals  are  1,146. 
Extra  vegetable  broth  may  add  200  calories,  making  a 
total  of  1,346  calories.  Of  this  323  are  protein. 

No.   3  Protein  Carbohydrate     Total 

BREAKFAST  Calories        Calories        Calories 

Juice  of  a  Grapefruit   (without  sugar)    ....     7  89  100 

Poached   Egg  on  Toast    39  80  200 

Olives    (8)  8  16  160 


Per  cent  of  protein  for  the  meal,  12.  54  135  4^0 

Per  cent  of  carbohydrate  for  the  meal,  40. 

Note  how  the  toast  increases  the  percentage  of  car- 
bohydrate, making  it  evident  why  diabetics  must  use 
bread  very  sparingly. 

Protein  Carbohydrate     Total 
DINNER  Calories        Calories        Calories 

Tomato  Gluten  Soup    23  74  103 

Gluten  Biscuit    (2)    60  81  150 

Cottage  Cheese  Omelet    (large  serving)    ...   73  21  200 

Cauliflower     6  4  12 

Brazil  Nuts   (3)    10  4  100 


Per  cent  of  protein  for  the  meal,  32.  172  154  565 

Per  cent  of  carbohydrate  for  the  meal,  32. 

4:  00  P.  M. 

Vegetable  Broth. 


254  THE  HOME  DIETITIAN 

Protein  Carbohydrate  Total 

SUPPER                                                                                  Calories        Calories  Calories 

Vegetable    Broth     35  48  100 

Lettuce  and  Almond  Salad  with  French 

Dressing      18  8  150 

Olives    (8)      8  16  160 


Per  cent  of  protein  for  the  meal,  15.  gi  72  410 

Per  cent  of  carbohydrate  for  the  meal,  18. 

In  preparing  the  salad,  use  with  the  lettuce  hearts,  6 
chopped  almonds.     Add  French  dressing. 

BEDTIME 

Vegetable  Broth. 

Total   calories    for   the    day,    including   all   vegetable 
broth,  are  1,635.     Total  protein  calories  equal  357. 

NO.   4  Protein  Carbohydrate     Total 

BREAKFAST  Calories        Calories        Calories 

Grapefruit  with  Almonds    : .   22  92  200 

Nut  Tomato   Toast    36  129  205 

Olives    (8)      8  16  160 

Per  cent  of  protein  for  the  meal,  12.  gg  237  565 

Per  cent  of  carbohydrate  for  the  meal,  27. 

Make  toast  according  to  the  recipe   17. 

Protein  Carbohydrate     Total 
DINNER  Calories        Calories        Calories 

Vegetable  Bouillon    24  53  93 

Cottage  Cheese  with  Cream    50  16  160 

Spinach  with  Lemon    8  11  25 

Apple  and  Celery  Salad   (with  no  dressing)  5  53  60 


Per  cent  of  protein  for  the  meal,  26.  37  133  333 

Per  cent  of  carbohydrate  for  the  meal,  39. 

For  the  salad,  use  1  medium-sized  apple,  1  or  2  celery 
stalks.     Dice  the  apple  and  chop  the  celery.     Mix. 

Protein  Carbohydrate     Total 
SUPPER  Calories        Calories        Calories 

Vegetable    Broth    35  48  100 

Scrambled  Eggs    50  . .  175 

Lettuce  with  French  Dressing   3  6  50 

Olives    (8)      8  16  160 


Per  cent  of  protein  for  the  meal,  19.  9^  70  485 

Per  cent  of  carbohydrate  for  the  meal,  14.5. 


PRINCIPLES   OF   FEEDING   THE   SICK  255 

This  meal  represents  one  especially  low  in  carbohy- 
drate. 

BEDTIME 

Vegetable  Broth. 

The  total  calories  for  the  day  equal  1,488.    Total  pro- 
tein calories  equal  284. 

No.   5  Protein  Carbohydrate     Total 

BREAKFAST  Calories        Calories        Calories 

Orange  Juice   (7  oz.)    7  90  100 

Soft  Eggs    (2)     50  ..  150 

Gluten  Biscuit    (2)    60  81  150 

Per  cent  of  protein  for  the  meal,  29.  117  171  400 

Per  cent  of  carbohydrate  for  the  meal,  43. 

Protein  Carbohydrate     Total 
DINNER  Calories        Calories        Calories 

Vegetarian  Consomme  (see  recipe  37)   36  25  65 

Baked   Potato    10  89  100 

Butter    . .  50 

Combination  Salad  with  French  Dressing  . .     7  24  85 

Olives    (8) 8  16  160 

Per  cent  of  protein  for  the  meal,  10.  61  154  460 

Per  cent  of  carbohydrate  for  the  meal,  35. 

In  cases  of  diabetes  of  moderate  severity,  potatoes  are 
allowable  in  limited  quantities. 

4:  00  P.  M. 

Vegetable  Broth. 

Protein  Carbohydrate     Total 
SUPPER  Calories        Calories        Calories 

Vegetable    Broth    35  48  100 

Carrot  and  Cottage  Cheese  Salad    69  21  170 

Olives    (8)      8  16  160 

Per  cent  of  protein  for  the  meal,  26.  112  85  430 

Per  cent  of  carbohydrate  for  the  meal,  19. 

BEDTIME 

Vegetable  Broth. 

Total  calories  for  the  day,  1,490.     Total  protein  cal- 
ories, 360. 


256  THE  HOME  DIETITIAN 

No.    6                                                                                     Protein  Carbohydrate  Total 

BREAKFAST                                                                               Calories  Calories  Calories 

Orange  Juice   (7  oz.)    7  9o  100 

Scrambled    Eggs     50  .  .  175 

Baked    Potato    10  89  100 

Butter     . .  50 

Olives    (8)      8  16  160 

Per  cent  of  protein  for  the  meal,  13.                75  ^95'  5g5 
Per  cent  of  carbohydrate  for  the  meal,  33. 

Protein  Carbohydrate  Total 

DINNER                                                                                        Calories  Calories  Calories 

Vegetable    Broth     35  48  100 

Cottage  Cheese  Omelet   (large  serving)    ....   73  21  200 

Beet    Tops .      9  13  32 

Fresh    Tomatoes     14  48  66 

Walnuts    ( 3 )    10  7  100 

Per  cent  of  protein  for  the  meal,  28.               141  137  493 
Per  cent  of  carbohydrate  for  the  meal,  27. 
4:  00  P.  M. 

Vegetable  Broth. 

Protein  Carbohydrate     Total 

SUPPER                                                                                        Calories  Calories  Calories 

Vegetable    Broth     35  48  100 

Nut  Tomato  Toast     36  129  205 

Grated  Carrots    (1  carrot)    5  25  35 

Almonds    (6)                                                            .    15  3  100 


Per  cent  of  protein  for  the  meal,  21.  91  205  440 

Fer  cent  of  carbohydrate  for  the  meal,  43. 

BEDTIME 

Vegetable  Broth. 

Total  calories  for  the  day,  1,723.     Total  protein  cal- 
ories, 377. 

No.    7  Protein  Carbohydrate     Total 

I ;  UK  A  K  FAST  Calorie.s        Calories        Calories 

Grapefruit     7  89  1  od 

Milk  Toast    33  110  200 

Poached  Egg   25  . .  75 

Pecans,  (10)     13  16  228 

Per  cent  of  protein  for  the  meal,  13.  73  215  603 

Per  cent  of  carbohydrate  for  the  meal,  35. 


PRINCIPLES   OF   FEEDING   THE   SICK  257 

Protein  Carbohydrate     Total 
DINNER  Calories        Calories        Calories 

Tomato  Bisque  Soup    14  48  75 

Gluten  Biscuit   (2)    60  81  150 

Baked   Potato    10  89  100 

Butter    . .  50 

Cottage  Cheese  with  Cream  50  16  160 

Cauliflower     6  4  12 

Olives    (8)      8  16  160 

Per  cent  of  protein  for  the  meal,  21.  ~148  254  707 

Per  cent  of  carbohydrate  for  the  meal,  34.5. 

4:  00  P.  M. 

Vegetable  Broth. 

Protein  Carbohydrate     Total 
SUPPER  Calories       Calories       Calories 

Vegetable  Bouillon  (see  recipe  23)    24  53  93 

Graham  Zwieback   (1)     14  80  100 

Grated  Carrot   5  25  35 

Olives    (8)      8  16  160 

Per  cent  of  protein  for  the  meal,  14.  51  "i74~  388 

Per  cent  of  carbohydrate  for  the  meal,  45. 

BEDTIME 

Vegetable  Broth. 

Total  calories  for  the  day,  1,898.  Total  protein  for 
the  day,  347. 

Many  cases  of  diabetes  do  not  need  to  be  so  greatly 
restricted  in  their  diet;  others  need  even  greater  re- 
striction for  a  time  at  least.  During  the  initial  period 
of  treatment,  it  may  be  necessary  to  so  completely  elim- 
inate the  carbohydrate  from  their  diet  that  their  total 
calories  may  be  1,000  or  below.  Their  chance  for  recov- 
ery, however,  will  usually  depend  upon  its  being  possible 
to  supply  them  necessary  vitamines  and  salts.  As  has 
already  been  said,  this  may  be  most  readily  accom- 
plished by  restricting  them  entirely  to  vegetable  broths. 
These  vegetable  broths  should  be  made  of  leaves  and 
skins,  these  supplying  more  vitamines,  salts,  and  pro- 

17 


258  THE  HOME  DIETITIAN 

teins,  with  the  least  amount  of  carbohydrate.  In  these 
broths  may  be  used  potato  skins,  carrot  skins,  tomatoes, 
celery  leaves,  spinach,  cabbage,  and  cauliflower,  or  any 
other  vegetables  of  a  leafy  nature.  The  caloric  value 
of  the  vegetable  broths  given  above  can  only  be  approx- 
imate, as  they  may  vary  greatly,  depending  upon  their 
mode  of  preparation  and  the  kind  of  vegetables  used. 
Try  the  following  recipe: 

4  potatoes  (scrub  well  and  peel) 

2  carrots  (scrub  and  peel) 

2  onions   (clean,  but  do  not  remove  skins) 

1  bunch  of  celery   (remove  tops) 

4  tomatoes  (do  not  peel) 

1  bunch  of  spinach 

1  small  head  of  cabbage 

Put  together  in  a  large  kettle  the  potato  and  carrot 
skins,  the  onions,  celery  tops,  tomatoes,  spinach,  and 
cabbage.  Cover  with  cold  water.  Bring  slowly  to  a 
boil.  Cook  for  one-half  hour,  then  place  in  a  fireless 
cooker  for  three  hours;  or  cook  slowly  on  stove  for  two 
or  three  hours.  Add  water  as  necessary.  Pour  off  the 
liquor,  of  which  there  should  be  about  one  quart;  salt 
and  serve.  One-half  pint  of  strained  tomato  may  be 
used,  if  necessary,  instead  of  fresh  tomato. 


CHAPTER  XXVII 

PRINCIPLES  OF  FEEDING  THE  SICK  AS  APPLIED 
IN  CHRONIC  INFECTIOUS  DISEASES 

OF  chronic  infectious  diseases,  we  may  take  tubercu- 
losis as  a  type.  In  this  condition  the  vitality  has  been 
lowered  to  such  an  extent  that  the  infecting  agent,  the 
tuberculosis  germ,  has  successfully  invaded  the  tissues, 
and  has,  to  a  greater  or  less  degree,  got  the  upper  hand. 
The  body  resources  are  not  sufficiently  strong  to"  quell 
the  invader.  In  some  cases,  the  infection  may  lie  dor- 
mant, not  making  much  headway.  In  others,  the  body 
forces  are  constantly  losing,  and  the  patient  finally 
succumbs. 

Due  to  Impoverished  Diet 

Many  of  these  patients  are  improperly  nourished  to 
begin  with.  In  fact,  it  has  been  said  that  tuberculosis 
is  indirectly  due  to  an  impoverished  or  a  deficient  diet, 
or,  in  other  words,  that  because  of  a  lack  of  proper 
nourishment  the  system  becomes  so  depleted  that  it  falls 
an  easy  prey  to  infection.  So,  to  nourish  these  indi- 
viduals properly  is  of  first  importance,  and  gives  them 
a  fighting  chance. 

There  is  an  imperative  need  for  large  quantities  of 
vitamines,  with  their  favorable  influence  on  all  vital 
processes.  There  is  increased  demand  for  alkaline  salts 
to  counteract  the  increasing  tendency  toward  acidity 
ever  present  in  chronic  infections.  Some  say  that  there 
is  need  for  extra  calcium  salts,  due  to  the  fact  that  the 
healing  process  is  dependent  upon  a  walling  off,  with 
calcification,  of  local  diseased  areas.  There  is  a  great 
necessity  for  added  protein  because  of  increased  tissue 

259 


260  THE  HOME  DIETITIAN 

waste.     How  to  supply  these  in  a  form  easily  used  by 
the  system,  is  the  great  question. 

Low-Grade  Fever 

Many  of  these  are  cases  of  long-continued  fever  of 
low-grade  type.  Such  are  bed  patients,  and  must  be  fed 
often,  as  in  any  prolonged  fever  case  (see  Chapter  XXV) , 
pushing  the  vitamines  and  salts ;  keeping  the  amount  of 
protein  up  to  the  amount  well  tolerated;  and  increasing 
the  caloric  total  gradually  as  the  patient  can  bear  it. 

All  of  these,  whether  running  a  temperature  or  not, 
have  more  or  less  toxemia,  and  the  outline  for  feeding 
must  "be  much  the  same  as  for  those  of  the  auto-intoxi- 
cation type.  (See  Chapter  XXVI.) 

Digestive  Disturbances 

Almost  without  exception,  patients  with  tuberculosis 
have  depressed  digestive  function,  their  first  symptoms 
often  being  those  of  dyspepsia.  There  should  therefore 
be  served  to  them  food  that  while  supplying  needed 
nourishment,  can  get  from  the  alimentary  tract  into  the 
blood  with  as  little  strain  as  possible  on  the  digestive 
organs.  Each  individual  case  must  be  studied  as  to 
personal  tastes  and  digestive  shortcomings;  foods  must 
always  be  given  with  due  regard  for  digestive  ability, 
and  should  not  be  pushed  beyond  the  point  where  the 
patient  can  well  take  care  of  them. 

Forced   Feeding 

Because  of  the  great  need  of  protein,  the  plan  of 
•'  forced  feeding,"  with  a  large  amount  of  milk  and 
eggs,  so  in  favor  a  few  years  ago,  did  good  in  many 
cases.  This  furnished  an  abundance  of  protein  as  well 
as  vitamines  and  salts.  But  the  large  amount  of  milk 
and  eggs  often  greatly  increased  the  toxemia,  thus, 
many  times,  overbalancing  the  good  which  might  have 


PRINCIPLES    OF   FEEDING   THE   SICK  261 

been  derived  from  the  high  protein  diet.  Therefore, 
whenever  possible,  the  diet  should  be  planned  in  such 
a  way  as  to  furnish  needed  nourishment  without  encour- 
aging intestinal  putrefactive  processes. 

As  to  feeding  possibilities,  we  give  the  following  out- 
line, which  will  need  modification  in  many  ways  for 
different  cases. 

To  Supply  Vitamines 

To  supply  vitamines,  fruit  juices  and  vegetable  broths 
should  be  given  freely  at  meals  and  between  meals.  For 
example,  the  patient  might  have  a  glass  of  fruit  juice 
one  hour  or  one-half  hour  before  each  meal  and  a  cup 
of  vegetable  bouillon  at  the  beginning  of  each  meal.  If 
this  seems  too  much  liquid,  the  broth  may  be  made  more 
concentrated  and  only  one-half  cup  taken  at  a  time.  Or 
the  vegetable  broth  may  be  taken  between  meals,  say 
two  hours  before  meals.  McKann's  recipe  for  vege- 
table soup  is  a  good  one.  It  is  as  follows:  Boil  cabbage, 
carrots,  celery,  parsnips,  spinach,  onions,  and  turnips 
together  for  two  hours ;  drain  off  the  liquor,  and  discard 
the  residue;  feed  the  liquor  as  soup  in  generous  quanti- 
ties. Other  vegetables,  of  course,  may  be  used  (see  reci- 
pes, Chapter  XXXI).  In  this  way  these  patients  may 
get  an  abundance  of  vitamines  and  mineral  salts  as  well 
as  from  300  to  500  calories  of  actual  food  value,  aside 
from  that  which  they  would  get  anyway  in  their  reg- 
ular meals. 

Milk  and  Eggs 

As  large  an  amount  of  milk  as  can  well  be  taken, 
affords  a  valuable  means  of  protein  supply,  and  here  it 
is  of  great  advantage  to  remember  that  boiled  milk  can 
be  taken  in  larger  quantities  than  raw  milk,  because  it 
is  so  much  more  easily  digested  (see  page  224).  So  this 
patient  may  well  have  at  least  a  quart  of  milk  a  day  to 


262  THE    HOME    DIETITIAN 

drink,  in  addition  to  that  cooked  and  served  with  his 
food.  This  milk  should  be  eaten;  that  is,  sipped  alter- 
nately with  other  food,  instead  of  being  drunk.  Ordi- 
narily it  is  better  to  take  milk  only  at  mealtime,  the 
only  food  taken  between  meals  being  fruit  juices  and 
vegetable  broth.  In  addition  to  this,  cottage  cheese  may 
be  served  to  him  in  various  ways  (see  recipes  48  and 
77).  He  may  take  buttermilk  with  or  without  the  addi- 
tion of  cream.  Two  eggs  daily  may  be  of  value  in  add- 
ing necessary  extra  protein,  and  may  in  some  cases  take 
the  place  of  so  much  milk.  If  able  to  take  all  of  the 
above  foods,  he  may  easily  get  protein  as  follows:  Milk, 
one  and  one-half  quarts,  protein  calories,  180 ;  two  eggs, 
protein  calories,  50;  cottage  cheese,  2  heaping  table- 
spoons, protein  calories,  60;  total  protein  calories,  290. 
In  addition  to  this,  the  protein  of  his  cereals,  vegetables, 
and  other  foods,  including  perhaps  a  dozen  almonds  daily, 
would  easily  bring  his  protein  up  to  350  or  400  calories 
daily.  This  excess  of  protein,  however,  would  be  neces- 
sary only  in  those  cases  where,  because  of  wasting,  there 
is  need  of  extra  tissue  building,  and  should,  of  course, 
be  adjusted  to  suit  the  patient.  Grains,  vegetables,  and 
fruits  should  be  used  freely, —  cereals  preferably  in  the 
form  of  dextrinized  cereals  and  as  gruels. 

Total   Calories 

The  total  amount  of  food  required  depends  upon  the 
degree  of  emaciation  of  the  patient,  but,  unfortunately, 
the  emaciated  patient  is  the  one  who  often  cannot  digest 
his  food.  Such  patients  may  need  to  be  limited  largely 
to  a  liquid  diet,  with  frequent  meals  consisting  of  fruit 
juices,  vegetable  broths  or  soups,  and  boiled  milk  with 
perhaps  oven  toast,  other  simple  foods  being  added 
gradually.  For  those  patients  who  can  take  more  of  the 
solid  food,  the  daily  calories  may  be  increased  in  va- 
rious ways;  e.  g.,  olives  at  each  meal,  perhaps  six,  thus 


PRINCIPLES    OF   FEEDING   THE   SICK  263 

in  the  three  meals  adding  300  calories  to  the  daily  total; 
two  or  four  dates  at  the  end  of  each  meal,  making  100 
to  200  more;  three  or  four  walnuts  daily,  adding  an- 
other 100;  a  little  additional  cream,  if  patient  takes  it 
well.  It  must  not  be  forgotten  that  in  all  infections, 
whether  acute  or  chronic,  an  excess  of  free  fat  should 
be  avoided.  Fats  are  better  derived  from  olives  and 
milk  than  from  butter  or  a  large  amount  of  cream. 

Do  Not  Overfeed 

It  cannot  be  too  emphatically  asserted  that  food  be- 
yond what  the  digestive  organs  can  handle  only  does 
harm;  that  it  is  the  food  digested,  not  the  food  eaten, 
that  nourishes  the  body.  It  may  be  better,  in  many 
cases,  to  lessen  the  total  amount  by  half  and  have  it 
digested  and  utilized  than  to  push  the  amount  to  some 
desired  total  and  produce  fatal  results,  because  of  indi- 
gestion and  increased  toxemia.  There  are  few  cases 
that  cannot  be  supplied  sufficient  yitamines,  salts,  and 
protein  by  following  the  principles  already  laid  down. 
But  to  overfeed  is  a  great  mistake  and  should  be 
avoided.  When  the  total  calories  must  of  necessity  be 
low,  by  all  possible  means  keep  the  protein  relatively 
high;  lessen  the  amount  of  the  more  purely  energy 
foods  and  limit  the  patient's  activities  in  accordance 
with  caloric  intake. 

Milk  Diet 

In  many  cases  of  tuberculosis  the  milk  diet  may  be 
carried  out  with  success  and  much  benefit  to  the  patient. 
(See  milk  diet,  Chapter  XXVIII.)  However,  the  same 
results  can  usually  be  obtained  by  an  intelligent  combi- 
nation of  other  foods,  supplying  in  a  less  monotonous 
form  the  valuable  food  elements  furnished  by  milk. 

In  all  chronic  infections  that  might  be  mentioned,  the 
basis  of  feeding  is  the  same.  Push  the  vitamines  and 


264  THE    HOME    DIETITIAN 

properly  nourish  the  individual.  First,  be  sure  of  suffi- 
cient protein,  then  add  energy  food  as  indicated.  Avoid 
intestinal  stagnation  and  putrefaction  by  boiling  the 
milk,  which  not  only  aids  in  its  digestion,  but  also  steri- 
lizes it;  by  using  the  lactic-acid  products,  as  buttermilk 
and  cottage  cheese;  and  by  using  only  eggs  which  are 
strictly  fresh  and  from  well-kept  hens. 

In  pyorrhea  the  thing  of  first  importance,  together 
with  necessary  dental  work,  is  to  change  the  basic  or 
constitutional  condition  by  a  well-balanced  diet,  includ- 
ing an  abundance  of  fresh  fruit  and  green  vegetables. 
And  in  all  chronic  infections,  no  matter  what  the  germ, 
the  importance  of  general  hygienic  measures  to  increase 
the  vital  resistance  of  the  patient  cannot  be  too  strongly 
emphasized.  Of  this  general  hygiene  the  dietetic  treat- 
ment is  ever  of  great  importance,  and  should  be  carried 
out  as  outlined  above.  This  insures  the  best  results 
from  any  other  treatment  or  necessary  medication. 


"  The  lack  of  defensive  essence  is  just  as 
potent  a  producer  of  disease  as  the  presence  of 
an  invading  toxin.  I  am,  indeed,  here  to  carry 
this  argument  a  step  farther  by  declaring  that 
all  disease  —  or  nearly  all  —  depends  not  so 
much  upon  the  presence  of  a  plus  as  upon  the 
absence  of  the  minus;  to  contend  that  were  it 
not  for  the  poverty  of  the  soil  in  defensive  es- 
sence, the  weeds  of  disease  would  never  grow." 
—  Williams,  at  meeting  of  British  Medical  As- 
sociation, July,  1920. 


CHAPTER  XXVIII 
MILK  AND  THE  MILK  DIET 

A    Complete    Food 

MILK  is  a  very  valuable  food,  and  forms  a  large  part 
of  the  diet  of  civilized  races.  For  this  reason,  a  thor- 
ough knowledge  of  milk,  its  food  value,  its  digestion  and 
utilization  in  the  body,  and  the  best  ways  of  using  it  in 
the  diet,  is  of  great  importance.  Milk  as  a  food  is  more 
nearly  complete  than  any  other.  It  contains  all  the 
known  vitamines,  water-soluble  B,  fat-soluble  A,  and 
water-soluble  C.  It  contains  mineral  salts,  being  slightly 
deficient  in  iron,  because  of  the  fact  that  the  young  ani- 
mal, for  whom  milk  is  intended,  is  born  with  a  good 
supply  of  iron  stored  up  in  its  body.  It  contains  com- 
plete protein  in  large  proportions,  100  calories  of  milk 
giving  19  or  20  calories  of  protein.  It  contains  a  large 
amount  of  fat,  50  per  cent  of  its  food  value  being  this 
concentrated  food  element.  It  contains  carbohydrate  in 
the  form  of  milk  sugar,  about  30  per  cent  of  its  food 
value  being  in  the  milk  sugar  which  it  contains.  It  con- 
tains a  large  amount  of  water,  87  per  cent  of  its  volume 
being  water.  Containing  no  cellulose,  it  does  not  have 
the  laxative  action  due  to  this  substance.  For  this 
reason,  a  milk  diet  may  be  considered  nonlaxative,  or 
constipating,  in  its  mechanical  effect  on  the  bowel.  But 
it  contains  all  the  food  elements  which  must  be  absorbed 
in  order  to  sustain  life. 

A   Disadvantage 

Its  disadvantages  as  a  sole  article  of  food  are  due 
largely  to  its  lack  of  cellulose  to  stimulate  the  bowel  to 
normal  action,  and  to  the  fact  that  it  is  more  or  less 

265 


266  THE    HOME    DIETITIAN 

subject  to  putrefaction  in  the  germ-laden  intestinal  tract. 
If  retained  long  in  the  bowel,  such  putrefactive  prod- 
ucts are  harmful  to  the  system. 

A  Solid   Food 

Because  of  the  acidity  of  the  gastric  juice,  and  the 
milk-curdling  action  of  one  of  its  ingredients, —  the 
rennet  ferment, —  milk  begins  to  form  curds  soon  after 
it  enters  the  stomach.  Thus  it  forms  in  the  stomach  a 
substance  of  more  or  less  solid  and  tough  consistency 
instead  of  the  simple  liquid  it  might  at  first  seem  to  be. 
This  solid  portion  of  the  milk  is  its  protein,  and  in  this 
solid  form  it  is  digested  by  the  pepsin  of  the  gastric 
juice.  The  fat  and  sugar  are  digested  later  in  the 
intestine. 

The  ease  of  milk  digestion  depends  upon  the  size  of 
the  curds.  It  has  been  found,  as  the  result  of  a  series 
of  experiments,  that  the  curds  formed  by  the  milk  tend 
to  coalesce,  so  that  even  if  milk  is  taken  in  sips,  large 
curds  may  be  formed  unless  the  sips  of  milk  are  alter- 
nated with  bites  of  other  food,  and  the  milk  is  more  or 
less  mixed  with  other  food  before  it  is  swallowed.  (See 
page  175.)  If  for  any  reason  milk  digestion  is  delayed, 
it  may  also  greatly  delay  the  digestion  of  other  food, 
and  as  it  passes  into  the  intestine  it,  with  the  food  ac- 
companying it,  may  be  in  a  condition  in  which,  in  the 
presence  of  the  germ  activity  of  the  intestinal  tract, 
putrefaction  very  rapidly  takes  place.  A  stagnant  con- 
dition often  results,  with  indigestion,  distress,  fermen- 
tation, and  gas  formation.  Poisons  may  be  formed  that 
overwhelm  the  liver,  get  by  into  the  blood  stream,  and 
tend  to  produce  ill  health.  For  this  reason,  in  what 
form  and  how  milk  is  taken,  is  of  great  importance. 

There  are  many  ways  in  which  milk  can  be  used  as 
a  food.  Let  those  who  usually  find  that  milk  does  not 
agree  with  them,  try  one  or  more  of  the  following: 


MILK   AND   THE    MILK   DIET  267 

1.  Buttermilk,  because  of  its  lactic-acid  content,  does 
not  favor  intestinal  putrefaction,   as  does   sweet  milk, 
because  the  germ  producing  lactic  acid,  is  antagonistic 
to  the  germs  of  putrefaction.    It  supplies  the  same  food 
value  as  milk,  except  the  fat  content.     This  lack,  how- 
ever, for  some  people  simply  facilitates  the  ease  of  di- 
gestion, but  if  the  food  value  of  whole  milk  is  desired, 
it  is  a  simple  matter  to  accomplish  this  result  by  the 
addition  of  about  two  tablespoonfuls,  or  an   ounce,  of 
average  cream  to  a  glass   (seven  ounces)   of  buttermilk. 

Many  people  attempting  to  use  buttermilk  complain 
that  it  causes  flatulence.  This  to  a  large  extent  may 
be  obviated  by  eating  the  buttermilk  with  a  spoon,  mix- 
ing it  in  the  mouth  with  other  food,  instead  of  drinking 
it,  as  is  usually  done.  Other  lactic-acid  products  of  milk, 
as  yogurt,  fermilac,  vitalait,  etc.,  are  good  also  and  may 
be  substituted  for  buttermilk. 

2.  Cottage  cheese.     Very  few  people  cannot  take  cot- 
tage cheese.     Like  buttermilk,  it  does  not  favor  intes- 
tinal   putrefaction.     It    is    a    solid    food    instead    of    a 
liquid,  and  so  does  not  introduce  into  the  stomach  an 
excess  of  liquid,  which  for  some  is  an  advantage.     (See 
page  177.)     It  supplies  a  large  amount  of  complete  pro- 
tein, which  is  often  needed  by  the  very  class  of  people 
who  do  not  seem  able  to  take  milk.     It  may  be  served 
plain  or  made  equivalent  to  whole  milk  by  the  addition 
of  cream.     It  may  be  combined  in  recipes  to  give  va- 
riety  (see  recipes  48  and  77).     Neufchatel  cheese  is  a 
lactic-acid  cheese  which  can  be  obtained  on  the  market, 
and,  if  fresh,  is  good.     Milk  curdled  by  the  use  of  the 
junket  tablet  is  in  a  form  that  can  be  masticated  and 
therefore  digested  with  ease. 

3.  Boiled  Milk.     As   has   already   been   suggested   in 
previous  chapters   (see  page  224),  it  has  been  demon- 
strated that  boiled  milk  is  much  more  easily   digested 


268  THE    HOME    DIETITIAN 

than  whole  milk,  because  of  the  fine,  flaky  curds  that 
are  formed.  These  are  much  more  easily  surrounded 
and  permeated  by  the  gastric  juice  than  are  the  large, 
tough  curds  of  raw  milk.  The  boiling  of  milk  also 
sterilizes  it,  and  if  it  is  taken  soon  after  boiling,  having 
been  kept  free  from  recontamination,  it  enters  the  di- 
gestive tract  a  sterile  substance.  Being  easy  of  diges- 
tion, it  passes  quickly  through  the  stomach  and  bowel, 
and  is  much  less  liable  to  intestinal  putrefaction  than 
that  form  of  milk  which  is  germ  laden  when  it  is  taken, 
and  because  of  its  large  curds,  passes  slowly  through 
the  alimentary  canal.  Boiled  milk  has  always  been  con- 
sidered constipating,  but  milk,  even  though  raw,  has 
nothing  to  recommend  it  as  a  laxative  food,  for  it  con- 
tains no  laxative  ingredient,  as  cellulose.  After  its 
water  is  absorbed,  it  leaves  a  concentrated  residue, 
which,  as  we  have  seen,  does  not  favor  natural  bowel 
activity.  When  unboiled,  there  is  a  greater  residue, 
because  of  the  large  curds,  but  this  favors,  if  anything, 
the  irritation  of  putrefaction  rather  than  the  normal 
stimulus  for  peristalsis.  The  helpfulness  of  boiled  milk 
in  diarrhea  is  due  to  the  fact  that,  because  of  its  ease 
of  digestion  and  absorption,  it  has  a  soothing,  nonirri- 
tating  action  which  tends  to  overcome  the  irritated 
condition  practically  always  present  in  diarrhea. 

Fresh  milk,  boiled  and  taken  soon  after  boiling,  is 
probably  not  to  any  great  extent  deprived  of  its  vita- 
mines,  but  a  diet  including  a  normal  amount  of  fruit 
and  vegetables  is  not  dependent  on  milk  for  its  vitamine 
content,  so  the  question  of  devitalizing  milk  by  boiling 
is  of  minor  consequence.  Milk  should  always  be  used 
fresh.  Boiling  should  never  be  depended  upon  to  make 
it  possible  to  use  old  or  stale  milk. 

4.  Skim  milk.  For  some  who  find  milk  fat  difficult 
of  digestion,  the  protein  of  milk  may  be  utilized  in  the 


MILK    AND    THE    MILK   DIET  269 

form  of  skim  milk.  As  a  rule,  for  these  the  milk  should 
be  boiled.  Boiled  skim  milk  is  one  of  the  very  simplest 
of  foods,  and  can  be  taken  by  any  one  who  can  take 
liquid  of  any  kind.  It  often  solves  the  feeding  problem. 

5.  Whole  raw  milk.    This,  if  certified  as  to  its  purity, 
can  be  taken  by  many  with  advantage.     As  a  rule,  it  is 
well  to  take  it  mixed  with  other  food,  as,  e.  g.,  bread 
and  milk,  or  on  cereal,  or  alternating  sips  of  milk  with 
solid  food.     Taken  in  this  way,  large  curds  are  not  so 
likely  to  be  formed. 

In  the  author's  opinion  it  is  never  wise  to  drink  milk 
between  meals  or  at  bedtime,  as  is  often  done,  except 
of  course,  as  is  necessary  in  the  frequent  feedings  of  a 
liq'uid  diet.  In  such  cases  the  feedings,  even  though  as 
often  as  every  hour,  may  be  considered  meals,  and  our 
rule  as  to  milk  "  between  meals  "  still  holds  good. 

6.  There  are  other  and  varied  ways  in   which  milk 
may  be  used  with  advantage,  as  in  soups,  sauces,  and 
other  cooked  dishes.     In  this  form  many  can  take  milk 
well  who  seem  unable  to  take  it  in  any  other  way. 

The   Milk  Diet 

Because  the  milk  diet  has  been  accorded  such  a  fol- 
lowing and  has  been  heralded  abroad  as  a  cure-all  for 
so  many  conditions  of  ill  health,  and  is,  in  many  cases, 
an  important  means  of  supplying  to  undernourished  in- 
dividuals essential  food  elements  in  an  easily  assimilated 
form,  we  believe  a  discussion  of  the  milk  diet  at  this 
time  will  not  be  out  of  place. 

The  milk  diet  supplies  to  the  one  taking  it  a  goodly 
amount  of  protein,  120  calories  to  the  quart,  with  total 
calories  of  640  to  the  quart.  It  also  contains  mineral 
salts  and  vitamines.  By  taking  milk  as  the  sole  article 
of  diet,  so  that  there  is  only  one  kind  of  food  to  tax 
the  digestive  organs,  the  patient  with  poor  appetite  and 


270  THE    HOME    DIETITIAN 

weak  digestion  is  able  to  take  and  assimilate  more  cal- 
ories than  in  any  other  way.  Four  quarts  daily  of 
milk,  the  least  amount  that  is  usually  considered  suf- 
ficient when  one  is  on  a  milk  diet,  supplies  a  total 
number  of  calories  equaling  2,600,  with  480  calories  of 
protein.  This  excess  of  protein  is  what  these  patients 
often  need,  and  if  for  a  time  more  can  be  taken,  it  thus 
increases  the  value  of  the  milk  diet  and  the  patients 
are  usually  gratified  by  a  marked  and  definite  gain  in 
weight.  This  gain  in  weight  often  gives  them  just  the 
reserve  they  need. 

In  many  cases  the  advantages  of  the  milk  diet  may 
be  derived  in  a  less  monotonous  way  by  following  the 
suggestions  given  in  Chapter  XXVI  for  cases  of  the 
auto-intoxication  type.  But  there  are  times  in  which  the 
definite  initial  start  obtainable  from  a  diet  restricted  to 
milk  is  of  great  advantage.  Many  an  individual  will 
accept  with  resignation  the  restrictions  of  the  milk  diet 
for  a  few  weeks,  who  lacks  the  faith  to  adhere  to  any 
other  plan.  It  becomes  an  easy  matter  then,  after  the 
initial  benefit  has  been  received,  to  accomplish  the  change 
back  to  a  normal  diet,  following  the  plan  of  Chapter 
XXVI. 

However,  when  it  seems  that  the  milk  diet  is  indi- 
cated, the  fact  that  milk  is  easy  to  digest  may  be  used 
to  great  advantage,  making  it  possible  for  those  to  take 
the  milk  diet  who  have  perhaps  been  ruled  out  as  un- 
suitable subjects,  those  who  have  never  seemed  able  to 
take  milk  in  any  form;  and  it  greatly  increases  the 
advantage  that  any  may  derive  from  this  diet. 

A  Safety  Measure 

But,  again  the  question  arises:  How  about  the  con- 
stipating action  of  boiled  milk  and  its  vitamine  content? 
First,  as  has  been  said,  the  milk  diet  may  always  be 


MILK   AND    THE    MILK   DIET  271 

considered  constipating,  even  though  the  milk  is  taken 
raw.  Artificial  means  must  always,  to  a  greater  or  less 
extent,  be  used  to  induce  necessary  bowel  activity,  and 
if  milk  is  boiled,  the  vitamine  supply  must  be  secured 
from  another  source,  this  other  source  being  always  a 
great  advantage  from  several  standpoints,  and  very 
helpful  in  combating  constipation.  Fruit  juice,  which 
is  the  added  source  of  vitamine  suggested,  makes  a 
very  valuable  and  satisfactory  addition  to  the  milk  diet. 
Just  as  we  add  orange  juice  to  the  diet  of  a  baby  who 
is  on  boiled  milk,  so  we  give  the  adult,  when  on  the 
milk  diet,  fruit  juices,  including  orange  juice.  A  sug- 
gestive program  for  the  milk  diet,  found  in  the  author's 
practice  to  be  very  satisfactory,  is  as  follows: 


7     A.     M. 

Fruit  juice  8   to  12   oz.     Preferably   orange  juice  or 

watermelon  juice.     In   some  cases  a  breakfast  of 

fruit  itself  has  been  allowed. 

8    A.    M. 

Boiled  milk     8  oz. 

9  "    " 

8    " 

10  "    " 

8    " 

11  "    " 

8    " 

12    M. 

8    " 

1    P.    M. 

Fruit  juice       8  to  12  oz. 

2  "     " 

Boiled  milk     8  oz. 

3  "    " 

8    " 

4  «    « 

8    " 

5  "    " 

8    " 

6  "    " 

8    " 

7  "    " 

8    " 

8  "    " 

8    " 

9  "    " 

Fruit  juice       8  to  12  oz. 

On  this  program  the  patient  begins  the  milk  diet  with 
three  quarts  of  milk  and  three  fourths  to  one  quart  of 
fruit  juice  daily,  making  a  total  of  about  2,300  calories. 
Gradually  increasing  the  milk  to  12  ounces  every  hour, 
brings  the  daily  milk  ration  up  to  four  and  a  half  quarts 
and  increases  the  total  calories  to  3,000  or  more.  Dur- 


272  THE    HOME    DIETITIAN 

ing  the  day,  when  the  appetite  becomes  cloyed  with  so 
much  milk,  there  may  be  substituted  at  any  time  for 
the  hourly  milk  ration  another  glass  of  fruit  juice,  or 
a  glass  of  buttermilk. 

The  attendant  constipation  usually  necessitates  daily 
enemas,  and  bowel  activity  is  favored  by  preceding  the 
morning  fruit  juice  by  a  cup  of  flaxseed  tea  made  from 
the  whole  seed,  then  strained,  and  taken  hot  with  lemon 
juice. 

Some  cases  are  able  to  take  more  milk  than  suggested 
above,  even  as  much  as  five  or  six  quarts  daily,  but  we 
have  found  it  no  great  advantage  to  push  the  milk  be- 
yond what  the  patient  can  take  with  comparative  ease. 
Some  patients  can  take  more  milk  if  a  portion  of  the 
cream  is  removed,  but  there  is,  of  course,  little  advan- 
tage in  this  because  of  the  lessening  in  the  caloric  value. 


"  Oh,  for  festal  dainties  spread 
Like  my  bowl  of  milk  and  bread; 
Pewter  spoon  and  boivl  of  wood, 
On  the  doorstone,  gray  and  rude!  " 


CHAPTER  XXIX 
FOOD    IDIOSYNCRASIES 

Principles  Versus  Rules 

No  two  individuals  can  eat  the  same  foods.  No  two 
need  the  same  diet,  either  in  kind  or  amount.  Rules 
in  dietetics  are  ever  misleading.  Principles  need  indi- 
vidual application,  and  what  is  good  for  one  person  may 
not  necessarily  be  best  for  another.  Dietetic  needs  vary 
with  individual  digestive  ability  and  metabolic  activity. 

Certain  classes  of  foods  are  more  easily  utilized  by 
some  people  than  others.  Some  can  digest  greater  bulk 
of  food  or  coarser  cellulose;  some  can  handle  a  greater 
amount  of  fat;  some  do  not  take  a  large  amount  of 
starch  or  sugar  well;  some  need  and  can  utilize  more 
protein;  others  may  need  to  keep  protein  food  within 
narrow  limits. 

All  of  these  individual  peculiarities  should  be  recog- 
nized and  the  daily  ration  planned  accordingly.  At  the 
same  time  natural  food  resources  are  so  varied  and 
unlimited  that  none  need  lack  a  complete  and  well- 
balanced  food  supply. 

Habits  of  eating,  food  likes  and  dislikes,  and  even,  to 
an  extent,  the  apparent  ability  of  the  digestive  organs 
to  care  for  food,  are  to  a  great  degree  the  result  of 
education.  Dietetic  habits  formed  in  childhood  and 
early  youth  usually  prevail  in  later  life,  the  individual 
often  being  very  persistent  in  the  thought  that  any 
radical  change  in  his  ways  of  eating  would  be  out  of 
the  question. 

A  Change  in  Mental  Attitude 

It  is  very  possible,  however,  for  any  individual  to 
learn  to  enjoy  new  foods,  new  combinations,  and  even 

18  273 


274  THE    HOME    DIETITIAN 

to  lose  his  relish  for  foods  of  which  he  was  at  one  time 
very  fond,  providing  there  be  a  sufficient  incentive  or 
chain  of  circumstances  to  give  him  a  willing  mind, 
or  to  change  his  mental  attitude.  Many  have  come  to 
have  a  dislike  for  some  food  formerly  enjoyed,  through 
some  circumstance  connected  with  the  eating  of  it. 
There  are  many  who  can  testify  to  a  great  change  in 
their  habits  of  eating  as  a  result  of  the  food  conserva- 
tion campaign  of  the  late  war.  Interested  in  the  food 
questions  of  the  day,  they  looked  at  foods  and  the  ques- 
tion of  eating  in  a  new  light,  and  their  mental  attitude 
became  such  that  it  was  comparatively  easy  for  them  to 
make  even  quite  radical  changes  in  their  food  prefer- 
ences. They  wanted  to  like  certain  things  and  found  it 
easy  to  do  so.  Many  now  enjoy  Graham  and  whole- 
wheat bread  who,  before  the  war,  countenanced  only 
white. 

New   Interests 

Travelers  in  the  Orient,  as  they  become  interested  in 
the  customs  of  the  people,  often  find  it  quite  possible  to 
partake  of  and  to  enjoy  foods  which  at  home  they  would 
never  choose.  Their  interest  changes  their  mental  atti- 
tude to  one  of  willingness  to  try  something  new  in  the 
food  line.  Likewise,  an  individual  thoroughly  interested 
in  his  own  physical  welfare  and  learning  that  a  change 
in  diet  would  be  beneficial,  can,  if  he  will,  right-about- 
face,  dietetically,  and  learn  to  eat  with  the  keenest  en- 
joyment those  things  which  before  contained  no  appeal 
for  him;  that  is,  provided  he  is  sufficiently  and  properly 
nourished  thereby. 

A  food  idiosyncrasy  is  a  condition  in  which  a  certain 
food,  ordinarily  a  good  food  and  well  borne  by  people  in 
general,  cannot  be  eaten  without  producing  disturbing 
symptoms,  even  to  the  extent  of  poisoning,  real  or 
apparent. 


FOOD  IDIOSYNCRASIES  275 

Real  food  idiosyncrasies  are  comparatively  rare  and 
will  be  discussed  later. 

Fancied  food  idiosyncrasies  are  frequent,  and  we  often 
hear  people  saying  that  they  cannot  eat  oranges,  take 
orange  juice  or  fruit  of  any  kind,  when,  if  they  could 
only  be  made  to  think  so,  by  a  little  planning  and  intel- 
ligent application  of  feeding  principles  they  might  find 
themselves  well  able  to  take  fruit.  There  are  many  who 
insist  that  milk,  in  any  form,  produces  indigestion; 
when  the  trouble  is  not  with  the  milk  but  in  the  way  it 
is  eaten. 

One  dear  little  lady,  after  eating  for  days  a  combi- 
nation that  would  be  a  tax  on  any  one's  liver,  when  she 
came  down  with  a  bilious  attack,  remembered  that  she 
had  eaten  an  egg  the  day  before,  and  wailed,  "  I  never 
could  eat  eggs." 

A  sufferer  from  asthma  happened  to  have  an  asth- 
matic attack  following  a  meal  in  which  an  innocent 
grapefruit  was  included.  Never  again  could  she  be  in- 
duced to  eat  grapefruit.  As  the  grapefruit  was  only  one 
of  many  foods  taken  at  this  meal,  just  why  it  should 
be  blamed  was  difficult  to  determine.  One  patient,  who 
insisted  that  beans  were  "  poison  "  to  her  and  who  never 
failed  to  suffer  the  expected  symptoms  upon  the  ingestion 
of  even  a  recognized  bean  flavor,  took  them  without  the 
slightest  untoward  result  when  bean  puree  was  served 
her  in  a  vegetable  soup  in  which  the  bean  flavor  was 
masked.  No  doubt  for  her  the  bean  cellulose  was  diffi- 
cult of  digestion,  but  she  failed  to  recognize  the  cause 
of  the  trouble  and  blamed  it  to  some  inherent  quality 
of  the  bean  itself,  the  fallacy  of  which  in  her  case  was 
quite  evident. 

Afraid  to  Eat 

There  is  no  phase  of  life  in  which  the  mental  attitude 
has  such  a  bearing  as  in  the  question  of  eating.  Some 


276  THE    HOME    DIETITIAN 

individuals  have  this  mental  anxiety  toward  food  devel- 
oped to  such  a  degree  that  all  food  causes  indigestion 
for  no  other  reason  than  that  it  is  expected  to  make 
trouble.  Many  are  deprived  of  necessary  food  elements 
and  die  of  malnutrition  and  deficiency  diseases,  because 
they  are  afraid  to  eat. 

One  cannot  live  unless  he  eats  to  live,  and  in  order 
for  the  system  to  carry  on  its  activities  the  diet  must  in- 
clude all  food  essentials.  The  depleted  system  of  the 
one  who  does  not  eat  cannot,  because  of  weakness,  prop- 
erly digest  any  food,  and  thus  a  vicious  circle  is  estab- 
lished which  must  be  broken  through  at  some  point. 
The  only  hopeful  point  is  that  which  offers  opportunity 
for  the  system  to  receive  its  necessary  nourishment,  no 
matter  what  may  be  the  remonstrance  of  a  weakened, 
nervously  warped  digestive  tract. 

Better  Digestive  Distress  than  Starvation 

Vitamine  and  protein  foods  must  be  supplied  freely, 
but  these  are  often  the  ones  that  people  of  this  type 
think  they  cannot  take.  Better  some  gas  and  distress 
for  a  time  than  death  from  starvation.  A  sensible  plan 
of  diet,  outlined  with  due  regard  for  digestive  weakness, 
should  be  followed  in  spite  of  some  consciousness  of  dis- 
comfort after  eating. 

What  is  often  termed  one's  experience  may  be  dis- 
torted by  fear,  prejudice,  and  even,  to  an  extent,  an 
unwillingness  to  yield  a  point.  We  give  the  following 
quotation  as  having  an  application  to  the  subject  in 
question : 

"  Real  experience  is  a  variety  of  careful  experiments, 
made  with  the  mind  freed  from  prejudice,  and  uncon- 
trolled by  previously  established  opinions  and  habits. 
The  results  are  marked  with  careful  solicitude,  and  an 
anxious  desire  to  learn,  to  improve,  and  to  reform  on 


FOOD  IDIOSYNCRASIES  277 

every  habit  that  is  not  in  harmony  with  physical  and 
moral  laws.  The  idea  of  others  gainsaying  what  you 
have  learned  by  experience,  seems  to  you  to  be  folly,  and 
even  cruelty  itself.  But  there  are  more  errors  received 
and  firmly  retained  from  false  ideas  of  experience  than 
from  any  other  cause,  for  the  reason  that  what  is  gen- 
erally termed  experience  is  not  experience  at  all ;  because 
there  has  never  been  a  fair  trial  by  actual  experiment 
and  thorough  investigation,  with  a  knowledge  of  the 
principle  involved  in  the  action."-  -  White. 

A  true  food  idiosyncrasy  is  a  hypersensitiveness  of 
the  body  to  certain  proteins,  resulting  in  the  production 
of  toxic  symptoms  whenever  these  proteins  are  taken. 
True  food  idiosyncrasies  do  occur,  and  they  should  be 
recognized. 

As  has  been  noted  elsewhere  (see  Chapter  VI),  pro- 
teins differ  greatly.  Food  proteins  are  different  from 
body  proteins.  There  is  a  great  variation  in  tissue  pro- 
teins of  the  same  animal  body  and  in  the  proteins  of 
different  plants  and  different  animals.  While  the  build- 
ing stones  that  make  up  proteins  in  the  beginning  are 
from  the  same  eighteen  structural  units,  yet  in  their 
many  combinations,  the  resulting  proteins  are  as  varied 
and  numerous  as  the  words  of  the  English  language. 

Foreign   Proteins 

All  proteins  not  a  part  of  the  blood  or  tissues  of  any 
animal  body,  are  foreign  proteins  as  far  as  that  animal 
is  concerned,  and  remain  so  until  the  protein  molecule 
is  broken  down  and  rebuilt  into  one  partaking  of  the 
nature  of  those  of  the  animal  itself.  This  breaking  down 
usually  takes  place  in  the  digestive  tract  of  the  animal, 
and  the  protein  is  absorbed  in  the  form  of  the  elemental 
amino  acids,  which  after  absorption  are  reunited  in  va- 
rious combinations  to  form  the  many  different  kinds  of 
tissue. 


278  THE    HOME    DIETITIAN 

A  Toxic  Element 

In  the  breaking  down,  or  digestion,  of  the  protein 
molecule  a  portion  is  set  free  which  is  toxic,  but  being 
eliminated  in  the  digestive  tract,  is  normally  without 
effect.  If  for  any  reason  the  protein  molecule  is  ab- 
sorbed before  proper  digestion,  it  enters  the  blood 
stream  as  a  foreign  protein.  There  may  be  an  effort  on 
the  part  of  the  tissues  to  break  it  down  with  the  elab- 
oration of  certain  ferments  for  this  purpose.  If  this 
digestion  in  the  tissues  is  accomplished,  the  toxic  ele- 
ment ordinarily  set  free  in,  and  eliminated  through,  the 
digestive  tract,  is  set  free  in  the  blood,  with  resultant 
toxic  symptoms.  The  ferments,  having  once  been  elab- 
orated for  the  tissue  digestion  of  this  particular  protein, 
persist,  and  the  body  becomes  sensitized  to  this  protein, 
symptoms  of  poisoning  ever  resulting  when  it  in  any 
way  reaches  the  blood  stream.  In  catarrhal  conditions 
of  the  digestive  tract,  with  the  ever  attendant  conges- 
tion of  the  mucous  membrane  often  resulting  in  an  ab- 
normally increased  absorptive  power,  proteins  may  be 
absorbed  before  disintegration,  and,  if  the  body  attempts 
to  digest  them  in  the  tissues,  toxic  symptoms  may  result. 

Anaphylaxis 

This  toxicity  results  only  if,  as  a  result  of  the  above 
combination  of  conditions,  the  body  becomes  sensitized 
to  this  protein.  This  condition  of  abnormal  sensiti- 
zation  is  known  by  the  name  anaphylaxis.  According 
to  Rosenau  anaphylaxis  may  be  considered  "  a  condition 
of  unusual  or  exaggerated  susceptibility  of  the  organism 
to  foreign  proteins." 

After  sensitization  once  occurs,  the  hypersensitiveness 
is  very  extreme,  so  much  so  that  a  very  small  amount 
of  the  offending  protein  may  cause  trouble;  not  only  if 
taken  through  the  digestive  tract  in  the  form  of  some 


FOOD  IDIOSYNCRASIES  279 

food  protein,  but  also,  in  some  cases,  the  infinitesimal 
amount  which  might  be  absorbed  through  the  respira- 
tory mucous  membrane,  as  in  hay  fever  due  to  pollen 
sensitization,  or  in  the  attacks  of  asthma  some  people 
have  when  in  close  proximity  to  horses,  and  called 
"  horse  asthma."  Certain  drugs,  by  reason  of  their  al- 
tering some  of  the  body  proteins,  cause  symptoms  of 
anaphylaxis.  Food  proteins  to  which  the  body  most 
often  becomes  sensitized  are  the  animal  proteins,  as  va- 
rious meats,  shellfish,  eggs,  milk,  and  occasionally,  straw- 
berries, gooseberries,  etc. 

Anaphylactic  symptoms  often  show  themselves  in  the 
skin  as  hives;  in  respiratory  reactions,  as  hay  fever, 
asthma;  and  in  various  digestive  disturbances.  These 
conditions  of  hypersensitiveness  may  be  hereditary,  or 
may  be  acquired  in  the  way  outlined  above. 

Sensitization  Tests 

There  are  protein  skin  tests  called  sensitization  tests 
that  can  be  made  to  determine  one's  sensitiveness  to 
certain  proteins,  and  these  should  be  made  in  all  cases 
of  suspected  anaphylaxis.  Where  such  a  condition  ex- 
ists, the  treatment  consists  in  avoiding  the  offending 
protein;  in  selecting  a  careful  diet  designed  to  clear  up 
any  abnormal  conditions  of  the  digestive  tract;  and,  in 
some  cases,  under  competent  supervision,  the  taking  of 
graduated  doses  of  the  protein,  with  the  hope  that  a  tol- 
erance for  it  may  be  established.  If  it  chances  to  be  the 
protein  of  oyster,  clam,  etc.,  it  may  not  be  worth  while 
to  bother  with  an  attempt  to  establish  body  tolerance 
for  it. 

There  are  really  very  few,  if  any,  natural  foods  prop- 
erly prepared  and  properly  eaten  that  will  cause  this 
condition  of  anaphylaxis.  Very  often  the  offending 
foods  are  those  which  might  be  questioned  from  other 


280  THE    HOME    DIETITIAN 

standpoints  than  that  of  peculiar  individual  idiosyncrasy. 
Food  idiosyncrasies  not  explainable  along  lines  of  ra- 
tional principles  of  feeding  are  seldom  met  with  and, 
in  most  cases,  need  cause  little  inconvenience  if  normal 
dietetic  principles  are  applied  in  every  case  with  nec- 
essary individual  application. 

-•"•**« 


"  An  impoverished  diet  produces  poverty  of 
the  blood.  Cases  of  disease  most  difficult  to 
cure  result  from  this  cause." —  White. 


CHAPTER  XXX 
SUMMARY  AND  CONCLUSION 

1.  OUR  bodies  are  made  up  of  the  food  we  eat.     "  As 
a  man  eateth,  so  is  he."     Quality  of  tissue  depends  on 
quality  of  food. 

2.  Food  may  be  of  poor  quality  when  eaten,  or  it  may 
become  contaminated  during  a  process  of  retarded  di- 
gestion, and  so  be  impure  as  it  enters  the  blood. 

3.  Excessive  quantity  is  sure  to  impair  quality  of  food 
and  of  the  food-laden  blood. 

4.  Chronic   disease   is   largely   due   to   defective   food 
analysis  in  the  body.     These  conditions  are  all  prevent- 
able.    Knowledge  is  power. 

5.  Know  food  values,  the  composition  of  foods,  and 
the  relation  of  food  elements  to  body  needs. 

6.  See  to  it  that  your  daily  ration  is  a  balanced  one. 
Do  not  consider  the  question  of  calories  an  arbitrary 
one.     Remember  that  individual  needs   and   conditions 
must  be  considered  and  rules  modified.     Estimate  your 
calories  for  two  weeks.     How  much  are  you  eating,  and 
is  it  the  right  amount?     Could  you  do  just  as  well  on 
less,  or  do  you  need  more?     Sit  in  judgment  on  your 
own  case. 

7.  Remember  that  excessive  calories  cannot  make  up 
for   deficient  vitamines;   that   the   body    cannot   utilize 
food    unless   the    necessary    physiological    ferments    are 
backed   up   by   an  ample   vitamine  supply.     Know  the 
vitamine  foods  and  avoid  a  devitalized  diet.     Eat  freely 
of  raw  foods,   and   do  not  forget  the   value   of   green 
vegetables. 

8.  Avoid  a  monotonous  diet,  and  thus  the  danger  of 
deficiency  in  quality  as  well  as  in  quantity  of  proteins. 

281 


282  THE    HOME    DIETITIAN 

9.  Do  not  consider  it  a  hardship  if  you  find  it  neces- 
sary from  the  standpoint  of  economy  to  limit  your  meat 
supply.    Remember  that  an  adequate,  properly  balanced 
diet  is  very  possible  without  the  use  of  flesh  food,  and 
that  the  fleshless  diet  offers  many  advantages  healthwise. 

10.  Keep  out  of  your  food  those  things  that  make  it 
"  hot  when  it  is  cold  "  and  that  tend  to  produce  irritated 
catarrhal  conditions  of  the  digestive  mucous  membrane. 
Remember  that  the  mucous  membrane  may  be  irritated 
not  only  by  condiments,  but  also  by  excessive  and  super- 
heated fats,  improperly  masticated  and  indigestible  food, 
and  by  cane  sugar  in  concentration. 

11.  Do  you  long  for  a  good  complexion?    Eat  less  free 
fat,  more  raw  carrots,  fresh  fruit,  and  green  vegetables. 

12.  Remember  that  your  health  and  efficiency  are  im- 
paired, your  possibilities  for  length  of  life  lessened,  by 
the  use  of  beverages  and  foods  which  continually,  even 
though    slightly,    stimulate   because   of   drug   principles 
that  they  contain. 

13.  Remember  that  bread  is  the  "  staff  of  life  "  only 
when  it  contains  its  nutritive  elements  entire,  and  that 
the   use   of  the   whole   grains   is   economy   from   every 
standpoint. 

14.  Regard   desserts   with   suspicion,   use   them   with 
caution,  and  when  used,  let  them  supply  a  need  rather 
than  serve  as  an  excess. 

15.  A   simple   variety  at   a   meal   is   a   great   advan- 
tage, and  the  best  combination  is  a  well-balanced  ration. 

16.  No  one  dietetic  plan  is  a  "  cure-all."     All  rules 
have  their  exceptions.     The  only  safe  plan  is  to  have  a 
thorough  understanding  of  dietetics  and  of  the  principles 
of  nutrition,  with  the  use  of  common  sense  and  good 
judgment  in  their  application. 

17.  The  physical  foundation  for  mental  and  spiritual 
growth  is  most  important.     The  greatest  work  that  can 


SUMMARY    AND    CONCLUSION  283 

be  accomplished  is  that  of  feeding  the  child  in  such  a 
way  as  to  insure  the  highest  type  of  physical,  mental, 
and  spiritual  development.  The  self-discipline  and  con- 
trol that  this  will  foster  is  not  the  least  of  the  good 
results. 

18.  Conserve  your   food   intelligently   and   thus   your 
health.     Economy  is  spending  not  less,  but  more  wisely. 
Much  that  is  expended  for  food  could  be  used  with  better 
and  far  more  lasting  advantage  in  some  other  way. 

19.  Remember    that    good    food    may   be   wasted,    or 
spoiled  in  the  preparation,  and  that  cooking  should  be 
a  science  as  well  as  an  art. 

20.  Remember  that  how  you  eat  is  quite  as  important 
as  what  you  eat,  if  not  more  so.     Food  eaten  properly 
is  much  less  liable  to  be  taken  in  excess.     Proper  and 
thorough  mastication  will  cover  a  multitude  of  dietetic 
sins.     If  you  must  hurry,  eat  less. 

21.  Allow  ample  time  for  stomach  digestion  by  suffi- 
cient rest  between  periods  of  work,  so  that  this  your 
faithful  friend,  upon  the  integrity  of  which  so  much  de- 
pends, may  not  give  out  before  its  time. 

22.  System  and   regularity  are  as  important  in   the 
work  of  the  digestive  tract  as  in  any  other  business. 
Therefore,  plan  for  regular  habits  of  eating.    Never  eat 
between  meals. 

23.  If  fluid  taken  at  meals  hinders  the  proper  masti- 
cation of  your  food,  go  on  a  dry  diet. 

24.  Do  not  forget  that  adherence  to  principle  in  eat- 
ing is  an  evidence  of  strength  of  character,  and  that  he 
who  eats  to  live  will  longer  live  to  eat. 

25.  Above  all,  do  not  be  a  fanatic. 

26.  If  you  are  sick,  remember  that  your  body  requires 
the  same  food  elements  as  in  health,  with  a  relative  in- 
crease in  vitamines,  mineral  salts,  and  complete  proteins, 
and  a  relative  decrease  in  bulk  and  in  calories. 


CHAPTER  XXXI 
RECIPES  —  SIMPLE,  ECONOMICAL,  HYGIENIC 

THIS  book  is  not  a  cookbook.  But  in  order  to  help 
the  housewife  make  practical  application  of  the  princi- 
ples laid  down  in  the  preceding  chapters,  and  to  acquaint 
her  in  a  measure  with  simple  hygienic  methods  of  cook- 
ery, we  append  a  few  representative  recipes  that  we 
trust  may  serve  to  introduce  her  into  the  art  and  science 
of  healthful  food  preparation. 

To  lend  variety,  many  of  these  recipes  may  be  modi- 
fied. The  housewife  already  versed  in  the  art  of  cook- 
ery may  often  be  able  to  improve  upon  the  recipe  given, 
but  we  trust  that  she  may  do  so  with  intelligent  regard 
for  food  values.  The  size  of  the  serving  may  often  vary, 
but  the  calories  given  for  the  entire  recipe  will  enable 
any  one  easily  to  estimate  the  value  of  any  sized  helping. 
A  few  of  the  recipes  have  been  received  directly  from  the 
bulletins  sent  out  by  the  United  States  Department  of 
Agriculture.  For  many  we  are  indebted  to  our  friends : 
Miss  Lenna  Frances  Cooper,  director  of  the  Battle  Creek 
Sanitarium  School  of  Economics,  and  author  of  "  The 
New  Cookery ;  "  Mr.  H.  S.  Anderson,  dietitian  of  the 
Loma  Linda  Sanitarium,  and  author  of  "  Food  and  Cook- 
ery ;  "  and  to  Mr.  E.  G.  Fulton,  for  many  years  pro- 
prietor of  the  Vegetarian  Cafeteria,  Los  Angeles,  and 
author  of  the  "  Vegetarian  Cookbook."  A  number  of 
recipes  have  also  been  taken  from  the  "  Manual  of  Reci- 
pes "  of  the  Washington  Sanitarium,  Washington,  D.  C. 

To  these  most  excellent  and  reliable  authorities  on  hy- 
gienic and  scientific  cookery,  we  would  recommend  those 
who  desire  to  inquire  further  into  the  detail  of  Modern 
Culinary  Art. 

284 


RECIPES 


285 


(A)  BREADS  AND  BREAKFAST  DISHES 

Whole- Wheat  Gems   ("  Manual  of  Recipes," 
Washington    Sanitarium) 


1  cup  milk 


1  cup  white  flour 
%  cup  whole-wheat  flour 
Salt  to  taste 


Break  egg  into  batter  bowl,  add  milk  and  salt.  Sift 
flour  before  measuring  and  add  it  a  handful  at  a  time, 
beating  briskly.  Do  not  stir.  Beat  thoroughly  for  a 
few  minutes,  then  pour  into  gem  irons,  heated,  but  not 
too  hot,  arid  slightly  oiled.  Bake  30  to  40  minutes. 

To  make  the  mathematical  calculation  plain,  we  will 
work  out  entire  the  simple  problem  of  estimating  the 
food  value  for  the  recipe  given  above,  referring  to  Table 
II  in  the  Appendix: 


: 
1  egg 

Protein 
25 

Fat 
50 

Carbo. 

Total 
75 

(seep.  331) 

1  cup  milk   

30 

83 

47 

160 

(seep.  331) 

1  cup  white  flour 

63 

15 

438 

516 

(see  p.  341) 

%  cup  whole-wheat  flour  .  .  . 
Salt 

60 

19 

314 

393 

(seep.  341) 

Total  calories  in  recipe  . .  178        167        799     1,144 

This  will  make  about  12  gems. 

Dividing  by  12,  we  find  that  each  gem  contains  15 
calories  protein,  14  of  fat,  67  of  carbohydrate, —  a  total  of 
96,  making  16  per  cent  protein,  15  per  cent  fat,  and  69 
per  cent  carbohydrate. 

2.  Graham  Puffs   ("  One  Hundred  Recipes,"  Lenna 
Frances    Cooper) 


1  egg 

1  cup  milk 


cups  Graham  flour 
teaspoon  salt 


Beat  egg,  add  milk,  salt,  and  lastly  the  Graham  flour. 
Beat  about  five  minutes  or  until  batter  is  smooth.     Fill 


286  THE    HOME    DIETITIAN 

hot  gem  irons  full  to  the  brim,  and  bake  in  a  moderate 
oven  20  to  30  minutes.     Number  of  puffs,  about  12. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

172  181  668  1,021  17  18  65 

In  one  puff: 
14  15  56  85  17  18  65 

3.  Corn  Bread  Without  Baking  Powder   ("Food  and 
Cookery,"  Anderson) 

1  cup  cornmeal  2      eggs  (separated) 

2  tablespoons  flour  1*4  cups  boiling  water 
1  tablespoon  sugar                             1%  teaspoons  salt 

Sift  dry  ingredients  together,  stir  smooth  with  one 
cup  of  boiling  water.  With  the  remaining  one-fourth 
cup  of  water,  make  a  batter  that  will  barely  drop  from 
the  spoon.  Beat  eggs  separately.  Fold  yolks  into  whites 
and  turn  them  into  the  batter,  folding  them  in  with  a 
wire  batter  whip;  mix  lightly,  yet  thoroughly.  Pour 
into  oiled  granite  pan  and  bake  in  a  moderately  hot 
oven  20  to  30  minutes.  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

110  125  545  780  14  16  70 

In  one  serving: 
18   •  21  91  130  14  16  70 

4.   Cream  Rolls   ("  Food  and  Cookery,"  Anderson) 

1%  cups  flour  %  cup  thin  cream 

y2  teaspoon  salt 

Sift  the  flour  and  salt  into  the  mixing  bowl,  pour  the 
cream  on  all  at  once,  and  draw  the  flour  in  from  the 
sides  of  the  bowl,  so  as  to  mix  evenly  and  not  stir  any 
into  batter.  Work  it  into  a  stiff  dough  in  the  bowl, 
then  turn  out  on  a  slightly  floured  board  and  work  to- 
gether for  a  'few  minutes;  roll  out  to  about  one-third 
inch  in  thickness,  with  a  dull  knife  cut  into  long  strips 


RECIPES  287 

about  one-third  inch  wide,  roll  on  board,  and  cut  into 
two-inch  lengths.     Lay  in  baking  pan,  leaving  a  little 
space  between,  and  bake  in  a  medium  oven  until  crisp 
and  a  light  brown.     Number  of  rolls,  24. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

106       226       681      1,013       12       22       66 

In  one  roll: 
5        9        28        42       12       22       66 

5.  Whole- Wheat  Sticks  ("Food  and  Cookery," 
Anderson) 

1      cup  flour  1%  tablespoons  oil 

%  cup  whole-wheat  flour  %  teaspoon  salt 

ys  cup  cold  water 

Emulsify  the  oil  by  beating  thoroughly  while  adding 
water  a  drop  at  a  time.  This  will  take  only  a  portion  of 
the  one-third  cup  of  water.  To  the  sifted  flour  and  salt, 
add  the  oil,  which  has  previously  been  emulsified,  and 
rub  evenly  through  the  flour.  Add  the  remainder  of  the 
water  all  at  once  and  mix  evenly.  Knead  on  a  board 
and  roll  out  into  one-third  inch  thickness. 

Cut  with  a  dull  knife  into  strips  one-third  inch  wide 
and  three  inches  long.  Bake  in  medium  oven.  Number 
of  sticks,  24. 


V^dlUllCQ     111     l^VAJ 

Protein              Fat 

.»c  . 

Carbohydrate 

Total 

Per  Cent 
Protein 

Per  Cent 
Fat 

Per  Cent 
Carbo. 

90                202 

578 

870 

10 

23 

67 

In  one  stick: 

4                   8 

24 

36 

10 

23 

67 

6.   Corn   Dodgers    ("  Food   and   Cookery,"   Anderson) 

1      cup  cornmeal    (preferably        1      tablespoon  brown  sugar 

toasted  lightly  in  oven)          y2  teaspoon  salt 
1%  tablespoons  vegetable  fat         1%  cups  boiling  water 

Mix  all  dry  ingredients,  add  the  fat,  and  pour  on  the 
boiling  water  all  at  once  and  stir  smooth.    A  few  table- 


288  THE    HOME    DIETITIAN 

spoons  of  water  may  be  added  if  needed  to  make  the 
batter  of  a  consistency  barely  to  drop  from  spoon  but 
not  run.  Drop  from  the  side  of  a  large  spoon  into  an 
oiled  baking  pan  in  oblong  shapes,  and  bake  in  a  quick 
oven.  Number  of  servings,  6. 

Calories  in  recipe: 

Per  Cent         Per  Cent      Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

52       225       487       764        7       30       63 
In  one  serving: 

9        37        81       127        7       30       63 

7.  Oatmeal  Bread  1  (Mrs.  Jessica  Hazard,  Official  Dem- 
onstrator Food  Conservation  Campaign) 

1  cup  milk  and  water  or   all         1       cup  rolled  oats 

water  2%  cups  wheat  flour   (or  sub- 

1  teaspoon  salt  stitute,  as  rice  flour) 

1  tablespoon  fat  %  cake  yeast  dissolved  in 

2  tablespoons  sugar  %  cup  warm  water 

Put  oats  through  mill  or  grinder.  Scald  the  liquid 
and  pour  it  over  the  rolled  oats,  then  add  the  sugar,  fat, 
and  salt.  Let  stand  until  about  lukewarm  (about  half 
an  hour).  Add  yeast.  Add  flour  and  knead.  Let  rise 
until  double  its  bulk.  Knead  again  and  place  in  pan. 
When  light,  bake  in  a  moderate  oven  45  to  90  minutes. 
Calories  in  recipe  : 


per 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

265  260  1,412  1,937  14  14  72 

In  average  slice: 
15  15  78  108  14  14  72 

8.   "  Rye  and   Injun  Bread  " 

2  cups  cornmeal  2  tablespoons  sugar 

4  cups  rye  flour  1  teaspoon  salt 

2  tablespoons  oil  1  cake  compressed  yeast 

4  cups  water 


1  United  States  Leaflet  No.  6  gives  the  same  recipe,  omitting  the  sugar  and  fat 


RECIPES  289 

Dissolve  yeast  in  cup  warm  water.  Scald  two-thirds 
cup  cornmeal  with  three  cups  water.  Let  stand  one-half 
hour  or  until  lukewarm,  and  add  yeast.  Then  add  2 
cups  rye  flour,  one-third  cup  cornmeal,  oil,  sugar,  and 
salt.  Let  this  sponge  rise.  When  light,  add  1  cup  corn- 
meal  and  2  cups  rye  flour.  Mold  into  two  loaves  as  soft 
as  can  be  handled.  Let  rise  until  twice  its  bulk.  Bake. 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

260  364  2,810  3,434  8  10  82 

In  average  slice: 
7  10  78  95  8  10  82 

9.    Home-Ground    Wheat    Bread    (Food   Thrift   Series 
No.  2,  United  States  Department  of  Agriculture) 

3      cups  wheat  meal  (or  2  cups        y2  cake  compressed  yeast 
wheat    meal    and    1    cup      1  level  teaspoon  salt 
white  flour)  1  level  tablespoon  sugar 

1^4  cups  lukewarm  water  1  level   tablespoon    shortening 

if  desired 

Mix  the  yeast  with  a  small  amount  of  lukewarm 
water;  dissolve  the  sugar  and  salt  in  the  rest  of  the 
water;  mix  the  two  solutions  and  add  all  to  the  meal 
(or  meal  and  flour).  Mix  thoroughly  so  that  all  the 
liquid  is  incorporated  in  the  mass,  cover,  and  set  in  a 
moderately  warm  place  to  rise.  After  about  two  hours, 
or  when  well  risen,  add  the  shortening  and  knead  well, 
adding  a  little  meal  if  necessary,  until  a  smooth,  elastic 
dough  has  been  formed.  Cover  and  set  aside  again  to 
rise  for  an  hour.  Knead  lightly,  form  into  a  loaf,  place 
in  a  greased  pan;  allow  to  rise  until  just  double  in  bulk 
(this  is  only  two  thirds  of  the  usual  rise  in  the  pan 
when  white  bread  is  made).  Bake  slowly  for  three 
fourths  of  an  hour. 

Calories  per  slice  would  vary  slightly  from  bread  as 
given  in  tables  Chapter  VI,  in  that  there  would  be  a 
somewhat  higher  proportion  of  protein. 

19 


290  THE    HOME    DIETITIAN 

10.   Oven  Toast   (Zwieback) 

Cut  bread  in  slices.  Brown  slowly  in  oven  until  crisp 
all  through.  Bread  may  be  dried  out  in  the  sunshine 
before  putting  in  oven.  (For  calories,  see  page  329.) 

11.  Fruit  Toast 

Use  any  canned  or  stewed  fruit,  or  fruit  juice.  Heat, 
thicken  slightly  with  cornstarch,  and  pour  over  mois- 
tened oven  toast.  Calories  in  one  serving: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

15  7  136  158  9y2  4y2  86 

12.  Prune  Fluff  Toast   ("  Manual  of  Recipes," 
Washington    Sanitarium) 

y2    cup   prune    puree    or  2       egg  whites 

marmalade  %  cup  sugar 

Vanilla  or  other  flavoring 

Add  sugar  and  flavoring  to  stiffly  beaten  whites.    Add 
prune  puree  and  beat  well.     Serve  hot  or  cold  on  mois- 
tened oven  toast.     Oven  toast  may  be  moistened  with 
cream  if  desired.     Number  of  servings,  6. 
Calories  in  recipe   (not  including  oven  toast) : 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

53        1       386       440       12       ..       88 
In  one  serving  (not  including  oven  toast) : 

9        ..       64       73       12       ..       88 

If  cream  is  added  to  the  oven  toast,  the  extra  calories 
can  easily  be  calculated. 

13.    Cream   Tomato   Toast 

1  cup  strained  tomatoes  %  cup  milk 

1  teaspoon  sugar  1      teaspoon  flour 

Heat  tomatoes,  add  sugar  and  salt.  Heat  milk,  thicken, 
and  add  slowly  to  heated  tomato.  (See  recipe  27.)  Use 
no  soda.  Serve  on  oven  toast.  Number  of  servings,  6. 


RECIPES  291 

Calories  in  recipe   (not  including  oven  toast): 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

31        68       109       208       15       33        52 
In  one  serving  (not  including  oven  toast) : 

5        11        18       34       15       33        52 

14.   Cream  Puree  of  Peas  on  Toast 

1  cup  peas  Flour 

1  cup   (or  less)   milk  Salt 

Press  peas  through  a  colander,  add  milk  and  salt,  and 
thicken.  Serve  over  moistened  oven  toast. 

Calories  in  recipe   (not  including  oven  toast) : 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

92       96       230       418       22       23       55 
In  one  serving  (not  including  oven  toast) : 
15        16        38        69       22       23       55 

15.  Cream  Egg  Toast 

1  pint  milk  Flour 

2  eggs  Salt 

Scramble  the  eggs,  add  milk,  thicken,  and  salt  to  taste. 
Pour  over  moistened  oven  toast.  Minced  parsley  may 
be  added. 

Calories  in  recipe   (not  including  oven  toast) : 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

118  274  146  538  22  51  27 

In  one  serving  (not  including  oven  toast) : 
19  46  24  89  22  51  27 

16.  Nut  Cream  Toast 

Make  cream  sauce  by  thickening  one  pint  of  milk 
with  flour.  Rub  one  tablespoon  of  peanut  butter 
smooth  with  water,  and  add.  Salt.  Reheat,  and  serve 
over  oven  toast.  Number  of  servings,  6. 


292  THE    HOME    DIETITIAN 

Calories  in  recipe   (not  including  oven  toast): 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

85       236       156       477       18       49       33 
In  one  serving  (not  including  oven  toast) : 
14        39        26        79       18       49       33 

17.  Nut  Tomato  Toast 

1  can  tomatoes  strained  2  tablespoons   browned  flour 

2  tablespoons  peanut  butter  Salt 

Emulsify  peanut  butter;  add  to  strained  tomato. 
Thicken  with  browned  flour.  Salt  to  taste.  Heat  and 
serve  over  whole-wheat  oven  toast  which  has  first  been 
dipped  in  hot  water.  Number  of  servings,  4  to  6. 

Calories  in  recipe  (not  including  oven  toast) : 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

80  143  196  419  19  34  47 

In  one  serving  (not  including  oven  toast),  if  four  servings: 
20  36  49  105  19  34  47 

18.  Hygienic  Hot  Cakes  ("Vegetarian  Cookbook," 
E.   G.   Fulton) 

2       eggs  y2  teaspoon  salt 

2      cups  bread  crumbs  1      tablespoon  sugar 

%  cup  flour  About  1%  cups  milk 

Mix  thoroughly  the  bread  crumbs,  flour,  salt,  and 
sugar.  Add  sufficient  milk  heated  to  140°  or  150°  to 
make  a  thick  pour  batter,  and  into  this  beat  the  yolks 
of  the  eggs.  Add  the  stiffly  beaten  whites  and  bake  on 
a  soapstone  griddle.  Be  careful  not  to  have  the  milk 
scalding  hot.  Number  of  cakes,  8. 

Calories  in  recipe: 

Per  Cent         Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

179  260  669  1,108  16  23  61 

In  one  cake: 
22y2  32%  83  138  16  23  61 


RECIPES  293 

19.   Oatmeal  Gruel 

3  tablespoons  rolled  oats,  or          1  pint  water 
2   tablespoons  oatmeal          Salt  to  taste 

Add  oats  to  the  salted  boiling  water.     Let   boil    10 
minutes,  then  cook  3  hours  in  a  double  boiler.     Strain 
and  add  one-half  cup  evaporated  milk  or  cream.     Num- 
ber of  servings,  3. 
Calories  in  recipe  if  milk  is  used: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate         Total  Protein  Fat  Carbo. 

49  105  122  276  18  38  44 
In  one  serving: 

16  35  41  92  18  38  44 

Calories  in  recipe  if  cream  is  used: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

31       223      102       356       9       63       28 
In  one  serving: 
10       74       34      118       9       63       28 

NOTE. —  While  usually  considered  invalid  dishes,  gruels 
make  a  pleasant  variation  from  the  monotony  of  the  ordi- 
nary mush  for  even  the  healthy  members  of  the  family. 
They  may  be  prepared  as  above  from  any  other  cereal. 
Very  nice  gruels  may  be  made  from  left-over  cereals. 
Reheat  the  left-over  cereal  and  thin;  press  through  a 
colander  or  strainer,  and  add  milk  or  cream.  Gruels 
may  also  be  made  from  corn  flakes,  shredded  wheat,  etc., 
by  softening  in  boiling  water,  running  through  a  col- 
ander, and  adding  evaporated  milk  or  cream. 

20.  Gluten  Gruel 

1  pint  boiling  water  %  cup  20-per-cent  gluten  meal2 

Salt  to  taste 

Add  gluten  to  the  boiling  water,  stirring  constantly. 
Boil  until  thickened  and  add  one-half  cup  cream  or 
evaporated  milk.  Number  of  servings,  6. 


2  Gluten  is  a  meal  made  from  wheat,  and  contains  a  higher  proportion  of  gluten 
(wheat  protein)  than  ordinary  flour.  This  can  be  obtained  from  the  Battle  Creek 
Sanitarium,  Battle  Creek,  Mich.  Two  grades  may  be  obtained,  containing  20- 
per-cent  and  40-per-cent  gluten,  respectively. 


294 


THE    HOME    DIETITIAN 


Calories  in  recipe  if  evaporated  milk  is  added: 


Protein 


Fat 
91 


Carbohydrate 
294 


Total 
474 


Per  Cent         Per  Cent     Per  Cent 
Protein  Fat  Carbo. 

18  19  63 


In  one  serving: 

28  30  98  156 

Calories  in  recipe  if  cream  is  added: 


Protein 
67 


Fat 
209 


In  one  servtng: 

22  70 


Carbohydrate 
274 


91 


Total 

550 


183 


18 

Per  Cent 
Protein 

12 


12 


19 


63 


Per  Cent     Per  Cent 
Fat  Carbo. 

38  50 


38 


50 


21.  Browned  Rice 

Put  rice  in  shallow  pan  and  place  in  a  moderate  oven 
for  about  three  fourths  of  an  hour,  or  until  rice  is  a 
golden  brown.  Stir  occasionally.  Then  cook  in  a 
double  boiler  until  tender.  Serve  with  milk  or  cream. 

For  calories  in  serving,  see  page  35. 

22.   Baked   Oats 

1  cup  oatmeal  or  rolled  oats          1  cup  milk 

Salt 

Place  oats  in  a  pan  or  baking  dish.     Cover  with  the 
milk.     Add  salt.     Let  stand  all  night.     In  the  morning 
bake  one  hour  in  a  moderate  oven.     Number  of  serv- 
ings, 6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

130       126       484       740       18       17       65 
In  one  serving: 
22        21        80       123       18       17       65 


(B)     SOUPS 

23.  Vegetable  Bouillon    ("  Manual  of  Recipes,' 
Washington    Sanitarium) 

1  pint  strained  tomatoes  2  medium-sized    onions 

1  pint  potato  water  %  cup  chopped  celery 

1  pint  split  pea  broth  or  bean  broth 


Protein              Fat 

Carbohydrate 

Total 

Per  Cent 
Protein 

143                      95 

317 

255 

26 

In  one  serving: 

24                  16 

53 

93 

26 

RECIPES  295 

Cook  tomato,  chopped  onion,  and  celery  together 
slowly  one  and  one-half  to  two  hours;  add  one  bay  leaf, 
a  pinch  of  thyme  and  sage,  broth  from  peas,  and  potato 
water.  Strain  through  strainer,  salt  to  taste,  reheat, 
and  serve.  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent     Per  Cent 
Fat  Carbo. 

17  57 

17  57 

(See  also  recipe,  page  258.) 

24.  Vegetable  Broth 

Parings  from  6  potatoes  The  tops  of  a  bunch  of  celery 

Parings  from  3  or  4  carrots  1  cup  or  more  of  spinach  water 

2  red  onions  Celery  salt 

1  cup   strained   tomato  Pinch  of  thyme  or  bay  leaf 

2  tablespoons  oatmeal  Salt  to  taste 

Scrub  thoroughly  all  vegetables  before  paring.  Put  to 
cook  in  cold  water.  Cook  all  the  vegetables  together 
with  the  oatmeal,  slowly  two  or  three  hours,  adding 
enough  water  so  that  there  will  be  about  one  quart  of 
broth  when  done.  Or,  after  cooking  for  one-half  hour, 
they  may  be  placed  in  a  fireless  cooker.  Strain,  and  add 
the  spinach  water  and  seasoning.  Reheat  and  serve. 
Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

143        62       195       400       35       15       50 
In  one  serving: 
24        10       33        67       35       15       50 

The  above  recipe  can  be  varied  in  many  ways.  More 
or  less  of  the  mentioned  vegetables  may  be  used,  and  to 
these  may  be  added  many  others,  as  lettuce  leaves,  cab- 
bage leaves,  turnip  parings,  etc. 

The  broth  may  be  served  without  the  spinach  water, 


296  THE    HOME    DIETITIAN 

substituting  water  drained  from  potatoes  or  other  vege- 
tables.    Whole  potatoes  and  carrots  may  be  used. 

25.  Potato  Soup  Stock 

5  or  6  large  potatoes  2  or  3  onions   (preferably  red) 

Scrub  thoroughly  and  cut  up  without  paring  potatoes 
or  removing  outer  onion  skins.  Put  to  cook  in  two 
quarts  of  cold  water.  Let  cook  till  done,  adding  more 
water  if  necessary.  Press  through  a  colander  or 
strainer.  The  potato  broth  and  puree,  of  which  there 
will  be  about  two  quarts,  may  be  used  as  a  basis  for 
the  following  soups,  as  well  as  for  many  others. 

In  the  making  of  this  soup  stock  there  may  be  cooked 
with  the  potato  and  onion  any  other  vegetables,  as  car- 
rots, tomato,  cabbage  or  lettuce  leaves,  celery  tops,  etc. 
Or  the  soup  stock  may  be  made  from  potato  parings 
alone,  with  or  without  the  parings  and  outer  leaves  of 
other  vegetables.  If  parings  alone  are  used,  it  will  be 
well  to  cook  with  them  two  tablespoons  of  oatmeal  or 
other  cereal,  that  the  soup  stock  may  have  sufficient 
body  to  it. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

50  10  420  480  11  2  87 

NOTE. —  As  much  of  the  protein  is  near  the  skin,  the 
more  of  the  skins  used  the  higher  the  relative  protein 
content,  until  a  broth  (without  the  pulp)  made  from 
vegetable  skins  and  leaves  alone,  may  have  the  following 
high  protein  value: 

Calories  in  two  quarts  vegetable  broth: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate         Total  Protein  Fat  Carbo. 

179  9  32  220  81  4  15 

26.  Cream  of  Potato  Soup 

Thin  potato  soup  stock  as  necessary  to  make  proper  con- 
sistency, add  one  cup  evaporated  milk,  one-half  teaspoon 


RECIPES  297 

thyme,  and  salt  to  taste.  Chopped  parsley  may  be  used 
as  seasoning  instead  of  the  thyme.  Use  no  butter  or 
other  fat.  Number  of  servings,  6. 

Calories  in  recipe: 

Per  Cent  Per  Cent  Per  Cent 

Protein              Fat          Carbohydrate          Total              Protein              Fat  Carbo. 

110                182                508                300                14                23  63 

In  one  serving: 
18  30  85  133  14  23  63 

27.  Cream  of  Tomato  Soup 

To  one  and  one-half  pints  potato  soup  stock,  add  one 
and  one-half  pints  strained  tomato.  Salt  to  taste,  and 
bring  to  boil.  To  the  hot,  but  not  boiling,  tomato  soup 
add  one  cup  of  hot  condensed  milk  to  which  a  little  salt 
has  been  added.  Serve  at  once.  Another  method  to 
prevent  curdling  is  to  put  all  ingredients  together  cold, 
then  heat  and  serve.  Never  use  soda.  Number  of 
servings,  6. 


v^anjnc 

Protein 

0      111      I  CVylJt/ 

Fat 

&  . 

Carbohydrate 

Total 

Per  Cent 
Protein 

Per  Cent 
Fat 

Per  Cent 
Carbo. 

115 

191 

366 

672 

17 

29 

54 

In  one 

serving: 

19 

32 

61 

112 

17 

29 

54 

28.  Tomato  Corn  Soup 

1  cup   potato   soup   stock  1  can  corn 

1  can  tomatoes  Salt 

Strain  tomatoes,  puree  can  of  corn,  or  use  without 
pureeing.     Add   both  to   potato   soup   stock.     Thin,   if 
necessary,  with  water  or  other  vegetable  broth.    Salt  to 
taste.     Heat  and  serve.     Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat         Carbohydrate         Total  Protein  Fat  Carbo. 

181  90  746  1,017  18  9  73 

In  one  serving: 
30  15  X24  169  18  9  73 


298  THE    HOME    DIETITIAN 

29.  Tomato  Gluten 

1  can  tomatoes  1       onion 

Tops  of  bunch  of  celery  y2  cup  gluten 

Strain  tomatoes.    Cook  celery  tops  with  the  onion  one 
hour  or  longer  and  add  the  broth  to  strained  tomato. 
Salt  to  taste.     Boil  and  thicken  by  pouring  in  gradually 
the  gluten,  stirring  well.     Number  of  servings,  6. 
Calories  in  recipe: 


Protein 

Fat 

Carbohydrate 

Total 

Per  Cent 
Protein 

Per  Cent 
Fat 

Per  Cent 
Carbo. 

141 

35 

443 

619 

22 

6 

72 

In  one 

serving: 

23 

6 

74 

103 

22 

6 

72 

30.   Cream  of  Corn  Soup 

To  two  pints  potato  soup  stock,  add  two  cups  canned 
corn  and  one  cup  evaporated  milk.  Add  water  if  neces- 
sary to  make  the  soup  the  proper  consistency.  Salt  to 
taste.  The  corn  may  or  may  not  be  put  through  a  col- 
ander before  adding  to  soup  stock.  Number  of  serv- 
ings, 8. 
Calories  in  recipe: 


Protein 
145 

Per  Cent  Per  Cent  Per  Cent 
Fat  Carbohydrate  Total  Protein  Fat  Carbo. 
237  699  1,081  13  22  65 

In  one 

serving: 

18 

30                  87                 143                 13                22                65 

31.   Cream  of  Bean   Soup 

Cook  two-thirds  cup  of  beans.  Press  through  a  col- 
ander and  add,  with  the  bean  broth,  to  one  pint  of 
potato  soup  stock.  Thin  as  necessary  and  add  one  cup 
evaporated  milk.  Season  with  thyme  and  salt  to  taste. 
Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

187       196       494       877       21       23       56 
In  one  serving: 
31        33        82       146       21       23       56 


RECIPES  299 

32.  Tomato  Bean  Soup 

1  can  tomatoes  strained  1  cup  beans 

1  pint  potato  soup  stock  Salt 

Celery  salt 

Cook  beans  and  press  through  a  colander;  add  toma- 
toes and  potato  soup  stock.  Thin,  if  necessary,  with 
water  or  other  vegetable  broth.  Heat,  season  with  salt 
and  celery  salt.  Number  of  servings,  6. 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

222  49  691  962  23  5  72 

In  one  serving: 
37  8  115  160  23  5  72 


33.  Cream  of  Pea  Soup 

Make  as  recipe  31,  using  green  peas  instead  of  beans. 
Number  of  servings,  6. 


VCUvJl  A.U 

O      O.JJ.      X  t/^AjJ 

\s  . 

Per  Cent 

Per  Cent 

Per  Cent 

Protein 

Fat 

Carbohydrate 

Total 

Protein 

Fat 

Carbo. 

169 

187 

465 

821 

21 

23 

56 

In  one 

serving: 

28 

31 

78 

137 

21 

23 

56 

34.  Cream  of  Celery  Soup 

Cook  with  the  potato  -'f'ck  the  tops  of  one  bunch  of 
celery.  Strain  and  add  milk  as  for  cream  of  potato  soup. 
Salt  to  taste.  Cut  up  celery  and  cook  it  separately.  Add 
cooked  celery  to  soup ;  heat  thoroughly  and  serve.  Num- 
ber of  servings,  6. 
Calories  in  recipe :  Per  Cent  per  Cenfc  per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

125  184  529  838  15  63 

In  one  serving: 
21  31  88  140  15  22  63 


300  THE    HOME    DIETITIAN 

35.  Cream  of  Spinach  Soup 

To  one  and  one-half  pints  of  potato  soup  stock,  add  one 
pint  of  spinach  water  or  of  spinach  puree.  Add  one  cup 
of  evaporated  milk,  salt  to  taste.  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

124       178       254       556       23       32       45 
In  one  serving: 
21       30       42       93       23       32       45 

NOTE. —  To  any  of  the  above  soups  may  be  added  the 
water  in  which  any  vegetable  has  been  cooked.  Various 
combinations  may  be  made,  with  many  pleasing  results 
in  delicious  and  savory  flavors.  Beet  juice,  turnip  water, 
asparagus  broth,  etc.,  may  be  added  in  varying  amounts, 
depending  upon  individual  preference,  and  there  need  be 
no  monotony  in  the  soups  served.  Cream  may  be  used 
instead  of  milk ;  or,  if  preferred,  the  soups  may  be  served 
without  the  addition  of  milk  or  cream.  If  served  with- 
out milk  or  cream,  it  may  be  an  advantage  to  thicken 
them  slightly  with  a  cereal,  as  gluten,  cream  of  barley, 
or  oatmeal.  Left-over  cereal  may  be  added  to  the  soups 
with  satisfactory  results.  In  addition  to  salt,  other 
seasonings,  as  parsley,  thyme,  bay  leaf,  sweet  basil,  may 
be  used.  But  no  fat  of  any  kind  need  ever  be  added. 

36.  Tomato  Bisque 

2  cups  strained  tomato  2  teaspoons    peanut   butter, 

1  cup  water  rubbed  smooth  in  water 

1  cup  bean  broth  or  potato  Salt 

water 

Put  all  together  and  cook  well.    Salt  to  taste.    Number 
of  servings,  4. 
Calories  in  recipe  if  made  with  bean  broth: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate         Total  Protein  Fat  Carbo. 

57  51  194  302  18  17  €5 

In  one  serving: 
14  13  48  75  18  17  65 


RECIPES  301 

Calories  in  recipe  if  made  with  potato  water: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat  Carbohydrate 

45  25  106  176  25  13  62 

In  one  serving: 
11  6  26  43  25  13  62 

37.   Vegetarian  Consomme 

Skins  of  6  or  8  potatoes  Tops  of  bunch  of  celery 

3  red  onions  Tops  of  bunch   of  carrots 

1  can  tomatoes,  strained 

Turnip  or  beet  tops  or  spinach  may  be  used.  Put  all, 
except  the  tomato,  to  cook  in  cold  water.  Cook  slowly 
one  and  one-half  to  two  hours.  Drain  off  the  rich  brown 
liquor,  to  which  add  the  tomato  juice,  and  salt  to  taste. 
Reheat  and  serve.  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

215        24       152       391       55        6       39 
In  one  serving: 
36        4       25        65       55        6       39 

38.  Corn  Chowder 

1  medium  onion  1  pint  tomato  water 

14  teaspoon  celery  salt  1  cup  canned  corn 

1  pint  bean  broth  1  cup  strained   tomato 

3  hard-boiled  eggs,  diced  Salt  to  taste 

3  potatoes,  diced  Pinch  of  sage 

Add  diced  potatoes  and  grated  onion  to  the  bean  broth 
and  tomato.  Cook  until  potatoes  are  tender,  add  rest 
of  ingredients  and  milk  to  make  two  quarts.  Thicken 
the  milk  slightly  before  adding.  Number  of  servings,  8. 

Calories  in  recipe:  perCent      perCent    perCent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

210  207  497  914  23  23  54 

In  one  serving: 
26  26  62  114  23  23  54 


302  THE    HOME    DIETITIAN 

39.  Vegex  Broth 

Mix  one  teaspoon  Vegex  with  one  cup  boiling  water, 
and  serve.  Vegex  may  be  added  in  this  proportion  to 
other  soups  and  to  gravies.  It  gives  a  very  meaty  flavor. 
Calories  in  serving  of  five  ounces: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo 

20  2  .  .  22  91  9 

NOTE. —  Vegex  is  a  vegetable  extract  obtainable  at 
large  grocery  houses.  There  are  other  like  preparations 
on  the  market,  as  herbex,  savora,  etc.,  which  may  be 
used  in  the  same  way. 


(C)     MEAT  SUBSTITUTES  AND  ENTREES 

40.  Bean  Croquettes 

2  cups  mashed  beans  Sage 

1  cup  tomato  pulp  with  juice  Salt 

1  egg   (or  more  if  desired)  Celery  salt 

1  minced  onion 

Mix,  roll  in  corn  flakes  or  oven-toast  crumbs  and  egg, 
shape  into  patties,  and  bake  in  oven.    Serve  with  brown 
sauce  or  tomato  sauce.     (See  recipes  68  and  69.)     Num- 
ber of  croquettes,  10. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

289       150       753      1,192       24       13       63 
In  one  croquette: 
29        15        75       119       24       13       63 

41.    Ribbon    Loaf    (Washington    Sanitarium) 

1  cup  navy  beans  1  cup  evaporated  milk 

1  cup  pink  or  kidney  beans          Salt 

Cook  separately  till  tender  and  quite  dry.  Salt  while 
cooking.  Rub  through  a  colander.  Add  one-half  cup 
of  evaporated  milk  (or  cream)  to  each  kind  of  beans. 


RECIPES  303 

Place  beans,  in  alternate  layers,   in  a  pan  and  brown 
slightly  in  a  moderate  oven.     Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

406  226  994  1,626  25  14  61 

In  one  serving: 
68  38  165  271  25  14  61 

42.  Potose  Patties  or  Loaf  :{ 

1  onion  grated  Salt  to  taste 

2  tomatoes  or  their  equivalent      1       egg 

in  canned  tomatoes  J/4  pound  can  of  protose 

Pinch  of  thyme  or  sage  1      cup  zwieback  crumbs 

Put  in  a  dish  all  the  ingredients  except  the  egg  and 
the  crumbs.  Moisten  the  crumbs  with  hot  water  or  hot 
vegetable  broth,  beat  egg  and  add  to  the  crumbs,  then  mix 
all  together  well.  The  whole  should  be  sufficiently  moist 
to  mold  into  patties.  Cut  the  patties  through  the  center 
and  brown  in  a  slightly  oiled  pan  over  the  fire  or  bake 
in  the  oven.  Or  it  may  be  baked  in  the  form  of  a  loaf. 
Serve  with  brown  gravy.  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

162  133  282  577  28  23  49 

In  one  serving: 
27  22  47  96  28  23  49 

43.   Protose  with  Onion 

1      pound  protose  %  teaspoon  salt 

1      cup   strained  tomato  2  large  onions 

Pinch  of  sage 

Slice  the  protose  and  the  onion  and  place  in  dish  in 
alternate  layers.     Cover  with  strained  tomato,  add  the 


3  Protose  is  a  food  preparation  manufactured  by  the  Battle  Creek  Health  Food 
Company,  Battle  Creek,  Mich.  Its  food  value  approximates  that  of  meat.  It  may 
be  obtained  at  any  grocery  store  carrying  Battle  Creek  Sanitarium  Foods,  or  by 
sending  direct  to  Battle  Creek.  A  like  preparation  under  the  name  Nut  Cero  is 
made  by  the  St.  Helena  Sanitarium  Food  Company.  Nuttolene  is  also  a  meat  sub- 
stitute, put  out  by  the  Battle  Creek  Health  Food  Company. 


304  THE    HOME    DIETITIAN 

salt  and  sage.  Bake  in  a  slow  oven  for  an  hour  or  more. 
Watch  carefully,  and  if  protose  seems  dry,  add  water. 
Brown  sauce  may  be  used  instead  of  tomato.  To  obtain 
best  results,  use  plenty  of  liquid.  More  satisfactory  re- 
sults may  be  obtained  by  covering  well  with  the  sauce, 
and  baking  in  a  covered  baking  dish.  Number  of  serv- 
ings, 8. 

Calories  in  recipe: 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

390  267  264  921  43  29  28 

In  one  serving: 
49  33  33  115  43  29  28 

44.  Braised  Protose 

Cut  one  pound  of  protose  in  half  slices  one-half  inch 
thick.     Lay  in  an  oiled  pan  and  warm  through  slowly 
in  a  moderate  oven.     Number  of  servings,  8. 
Calories  in  recipe: 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

390       269       264       921       43       29       28 
In  one  serving: 
49        33        33       115       43       29       28 

45.   Nut  Fillet 

y2  lb.   nuttolene  Salt 

%  lb.  protose  Celery  salt 

1      onion  Sage 

Brown  sauce   (see  recipe  68) 

Cut  nuttolene  and  protose  in  half  slices  one-fourth  inch 
thick.  Arrange  in  an  oiled  pan  a  layer  each  of  protose  and 
nuttolene,  with  a  slice  of  onion  between,  placing  nutto- 
lene on  the  bottom.  A  toothpick  through  the  center  of 
each  layer  will  hold  protose  and  nuttolene  in  place. 
Sprinkle  with  salt,  celery  salt,  and  sage.  Cover  well 
with  brown  sauce  and  bake  about  three  fourths  of  an 
hour  in  a  moderate  oven.  Strained  tomatoes  or  tomato 


RECIPES  305 

sauce  may  be  used  instead  of  brown  sauce.     Number  of 
servings,  8. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

353      363      276       992       36       37       27 
In  one  serving: 
45        46       35       126       36       37       27 

46.  Protose  and  Potato  Hash 

4  to  6  potatoes  1  chopped  onion 

y2  lb.  protose  Salt 

Chop    potatoes,    protose,    and    onion,    and    mix    thor- 
oughly.   Brown  in  a  skillet  or  in  an  oven.     The  mixture 
may  be  formed  into  patties  if  desired.    Number  of  serv- 
ings, 6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

249  137  646  1,032  24  13  63 

In  one  serving: 
41  23  108  172  24  13  63 

47.  Homemade  Protose 

2  cups  peanut  butter  3  tablespoons  cornstarch 

2  cups  mashed   beans  1  teaspoon   chopped   onion 

4  cups  water  (or  better,  potato      Pinch  of  sage 

water    or    other    vegetable      Salt  to  taste 

broth) 

Mix  ingredients  thoroughly,  and  steam  in  double 
boiler  three  hours,  stirring  occasionally.  Let  cool.  Run 
knife  around  edge  and  turn  out.  Cut  in  slices.  It  may 
be  served  cold  with  tomato  sauce  or  used  in  any  recipe 
calling  for  protose.  This  will  make  about  three  pounds 
of  protose  and  24  servings. 
Calories  in  recipe :  per  ^  per  c<mt  per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

715  1,887  952  3,554  20  53  27 

In  one  serving: 
30  79  40  149  20  53  27 

20 


306  THE    HOME    DIETITIAN 

NOTE. —  This  protose  is  much  higher  in  fat,  with  less 
protein,  than  Battle  Creek  Sanitarium  protose.  How- 
ever, it  is  fairly  high  in  protein  and  may  be  used  with 
advantage.  Care  should  be  taken  that  it  be  served  with 
gravies  not  too  rich  in  fat. 

48.   Cottage   Cheese   Omelet 

2      eggs  14  teaspoon  salt 

%  cup  milk  1/2  cup  cottage  cheese 

Add  milk  and  salt  to  the  egg;  beat  thoroughly.  Add 
cottage  cheese  and  beat  again.  Bake  in  a  moderate 
oven  twenty  to  thirty  minutes.  Number  of  servings,  2. 
Calories  in  recipe: 


Protein 

Fat 

Carbohydrate 

Total 

Per  Cent 
Protein 

Per  Cent 
Fat 

Per  Cent 
Carbo. 

125 

182 

37 

344 

36 

53 

11 

In  one 

serving: 

62 

91 

18 

171 

36 

53 

11 

49.  Cottage  Cheese  and  Nut  Roast  (Food  Thrift  Series 
No.  2,  United  States  Department  of  Agriculture) 

1  cup  cottage  cheese  2  tablespoons  chopped  onions 

1  cup  chopped  English  walnuts      Juice  of  y2  lemon 

1  cup  bread  crumbs  Salt  to  taste 

Cook  the  onion  slowly  in  a  little  water  until  tender. 
Mix  the  other  ingredients  and  moisten  with  the  water 
in  which  the  onion  has  been  cooked.    Pour  into  a  shallow 
baking  dish  and  brown.     Number  of  servings,   10. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

295  1,044  334  1,673  18  62  20 

In  one  serving: 
30  104  33  167  18  62  20 

50.  Boston  Roast    (Food  Thrift  Series,   United  States 

Department  of  Agriculture) 

2  cups  mashed  beans  2  tablespoons  chopped  onion 
1  cup  cottage  cheese  Salt 

Bread  crumbs  as  needed  Celery  salt  or  sage 


RECIPES  307 

Cook  onions  in  a  little  water  until  tender.  Add  onions 
and  cheese  to  the  beans  and  bread  crumbs  to  make  mix- 
ture stiff  enough  to  be  formed  into  a  roll.  Bake  in  a 
moderate  oven,  basting  occasionally  with  a  little  oil  and 
water.  Serve  with  tomato  sauce.  (See  recipe  69.) 
Number  of  servings,  10. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

380       134       677      1,191       32       11       57 
In  one  serving: 
38        13       68       119       32       11       57 

51.   Carrot  and   Nut  Loaf 

1  cup  mashed  carrots  %  cup  chopped   walnuts 

2  eggs  Bread  crumbs  as  needed 
1  onion  minced  Salt 

Mix  thoroughly,  adding  enough  bread  crumbs  to  make 
it  the  proper  consistency.     Bake  in  oiled  pan,  slice,  and 
serve  with  tomato  sauce.     Number  of  servings,  8. 
Calories  in  recipe  without  sauce: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

127       578       193       898       14       64       22 
In  one  serving: 
16        72        24       112       14       64       22 

52.  Eggplant  Croquettes 

1  medium-sized  eggplant  2   (or  3)   eggs,  well  beaten 

Bread  or  cracker  crumbs  Salt  to  taste 

Boil,   drain,   and   mash   eggplant,   and  add   bread  or 
cracker  crumbs  until  right  consistency  to  handle.    Shape 
into  croquettes,  and  roll  in  bread  or  cracker  crumbs. 
Bake  in  oiled  pan.     Number  of  servings,  8. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

141  184  555  880  16  21  63 

In  one  serving: 
18  23  69  110  16  21  63 


308  THE    HOME    DIETITIAN 

53.   Celery  and   Nut  Roast 

2       eggs  1       cup  chopped  celery 

iy2  cups  milk  iys  cups  fine  toasted  crumbs 

%  cup  finely  chopped  nuts  1       teaspoon   salt 

1       tablespoon  grated  onion 

Beat  the  eggs,  add  milk,  nuts,  salt,  crumbs,  onion,  and 
celery.  Let  stand  twenty  minutes.  Bake  in  an  oiled  tin 
about  thirty  minutes  or  until  well  browned.  To  remove, 
turn  upside  down  on  a  platter  and  cover  with  a  cloth 
wrung  out  of  cold  water,  allowing  it  to  stand  a  few  min- 
utes or  until  loosened  from  the  pan.  Garnish  with  pars- 
ley and  serve  with  parsley  sauce  or  cream  sauce.  Num- 
ber of  servings,  8. 

Calories  in  recipe  without  sauce: 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

212       943       356      1,511       14       63       23 
In  one  serving: 
26       118        45       189       14       63       23 

54.   Nut   Tomato   Rice 

Make  sauce  same  as  for  recipe  17.  Boil  one  cup  of 
rice.  Add  sauce.  Reheat  and  serve,  or  bake  in  a  mod- 
erate oven  for  twenty  minutes.  Number  of  servings,  6. 

Calories  in  recipe: 

Per  Cent         Per  Cent      Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

154  150  930  1,234  13  12  75 

In  one  serving: 
26  25  155  206  13  12  75 

55.   Nut  Tomato  Macaroni 

Prepare  as  in  recipe  54,  but  bake  thirty  to  forty  min- 
utes.    Number  of  servings,  6. 
Calories  in  recipe :  per  ^      pgr  Cent    per  c&nt 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

139  152  520  811  17  18  65 

In  one  serving: 
23  25  87  135  17  18  65 


RECIPES  309 

56.  Puree  of  Green  Peas  with  Tomato  Sauce 

1      cup  pea  purge  y2  cup  zwieback  crumbs 

2  tablespoons  evaporated  milk 

Mix  well  and  salt  to  taste.  Bake  in  a  moderate  oven. 
For  tomato  sauce,  see  recipe  69.  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

129        96       479       704       18       14       68 
In  one  serving: 
21       16       80      117       18       14       68 

57.   Croquettes  of  Split  Peas   ("  Food  and  Cookery," 

Anderson) 

1      cup   mashed  peas  2  teaspoons  cream 

%  cup  oven-toast  crumbs  1  tablespoon  grated  onion 

Put  the  cream  and  onion  into  a  small  saucepan  on  the 
stove  and  reduce  to  about  one  third.  Mix  all  ingredients 
well,  roll  into  round  balls  about  the  size  of  an  egg,  and 
form  into  oblong  croquettes  with  a  knife,  having  them 
about  one  inch  thick,  one  inch  wide,  and  one  and  one-half 
inches  long.  Mark  the  top  with  a  knife.  Brush  over 
lightly  with  milk  or  cream  and  bake  on  the  top  grate  in 
a  hot  oven.  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate         Total  Protein  Fat  Carbo. 

76  92  277  445  18  21  61 

In  one  serving: 
13  15  46  74  18  21  61 

NOTE. —  Croquettes  may  be  made  in  this  way  from 
any  legume  or  from  corn. 

58.  Baked  Puree  of  Lentils  with  Tomato  Sauce 

1      cup  lentil  pure"e  2  tablespoons  evaporated  milk 

%  cup  zwieback  crumbs 

Mix  well.  Salt  to  taste.  Bake  in  moderate  oven.  For 
tomato  sauce,  see  recipe  69.  Number  of  servings,  6, 


\_ycm-n  JLV/O    111    j.  ^vi|j 

Protein             Fat 

c  • 

Carbohydrate 

Total 

Per  Cent 
Protein 

133                  92 

467 

692 

20 

In  one  serving: 

22                 15 

78 

115 

20 

Per  Cent     Per  Cent 
Fat  Carbo. 


310  THE    HOME    DIETITIAN 

Calories  in  recipe: 

Per  Cent        Pe 
Carbohydrate          Total  Protein 

13  67 

13  67 

(D)      VEGETABLES 

59.  Browned  Potatoes 

1  quart  steamed  potatoes  1  pint  brown  sauce 

(about  6) 

Place  the  potatoes  in  a  dripping  pan  and  cover  with 
brown  sauce  (see  recipe  68) .    Put  in  the  oven  and  bake 
twenty  to  thirty  minutes.     Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

117       17       639       773      15       2       83 
In  one  serving: 
19        3       107       129       15        2       83 

NOTE. —  The  same  recipe  may  be  used,  using  potatoes 
raw  instead  of  steamed  and  baking  them  until  tender. 
More  brown  sauce  will  be  needed. 

60.   Potato  Puffs    ("Manual  of  Recipes,"  Washington 

Sanitarium) 

Add  two  eggs  to  one  quart  well-beaten  mashed  pota- 
toes, beat  well.     Drop  on  oiled  tin  and  brown  in  hot 
oven.     Number  of  servings,  8. 
Calories  in  recipe: 


V^CHV/1  1C 

Protein 

0      111      1  GV1JJ 

Fat 

c  * 

Carbohydrate 

Total 

Per  Cent 
Protein 

Per  Cent 
Fat 

Per  Cent 
Carbo. 

123 

295 

500 

918 

13 

32 

55 

In  one 

serving: 

15 

37 

62 

114 

13 

32 

55 

61.  Stuffed  Potatoes 

Bake  large  potatoes.     When  done  remove  from  oven. 
Cut  in  halves  lengthwise,  and  remove  from  skins.    Place 


RECIPES  311 

all  together  in  pan.     Mash  well,  beating  till  fluffy;  add 
evaporated  milk  or  cream.     Salt  to  taste.     Replace  in 
skins,  brown  for  a  few  minutes  in  oven,  serve. 
Calories  in  potato  when  ready  to  serve: 

Per  Cent         Per  Cent      Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

16  31  88  135  12  23  65 

62.  Spinach  Souffle   ("The  New  Cookery,"  Lenna 
Frances  Cooper) 

1      cup  minced  spinach  %  cup  milk 

3      eggs  beaten  separately  *4  cup  flour 

y2  teaspoon  salt 

Rub  flour  and  salt  together;  heat  the  milk  and  add 
slowly  to  the  above,  stirring  to  keep  smooth;  then  add 
the  spinach,  the  yolks  beaten  well,  and  lastly,  the  stiffly 
beaten  whites.  Bake  twenty  to  thirty  minutes  in  a  mod- 
erate oven.  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

136       227       174       537       26       43       31 
In  one  serving: 
23       38        29        89       26       43       31 

63.  Spinach 

Wash  thoroughly.  Put  to  cook,  adding  very  little,  if 
any,  water.  Watch  carefully  so  it  does  not  scorch,  or 
cook  it  in  a  double  boiler.  Cook  twenty  to  thirty  min- 
utes. When  done,  drain,  chop  fine,  and  salt.  Serve  with 
lemon,  and,  if  desired,  sliced  hard-boiled  eggs.  Add  no 
fat.  For  calories,  see  pages  334  and  344. 

Another  very  satisfactory  way  to  cook  spinach  is  to 
steam  it.  Do  not  put  directly  in  steamer,  but  set  in 
steamer  the  pan  in  which  it  is  to  be  cooked.  Cover  well, 
so  that  steam  will  come  in  contact  with  spinach  over 
sides  of  smaller  pan.  Other  vegetables  may  be  cooked  in 
this  way. 


312  THE    HOME    DIETITIAN 

64.  Scalloped  Eggplant 

1  eggplant  1  egg 

1  cup  milk  %  cup  oven-toast  crumbs 

Salt 

Quarter  the  eggplant  and  cook  in  boiling  water  until 
tender.  Drain,  salt,  and  beat  up  with  a  fork.  Add  milk, 
egg,  and  oven-toast  crumbs.  Corn  flakes  or  cracker 
crumbs  may  be  used  instead  of  the  toast  crumbs.  Season 
with  sage  if  desired.  Bake  thirty  minutes  in  moderate 
oven.  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

108       164       293       565       19       29       52 
In  one  serving: 
18        27        49        94       19       29       52 

65.  Baked  Carrots 

Slice  four  large  carrots  and  place  them  in  baking  dish 
with  alternate  layers  of  corn  flakes.     Cover  with  milk. 
Season  with  salt.     Bake  in  slow  oven  about  forty-five 
minutes.     Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

54       99       162       315       16       30       54 
In  one  serving: 
9       16       27       54      16       30       54 

NOTE. —  For  bananas  served  as  a  vegetable,  see  recipes 
108  and  109. 

(E)      GRAVIES 

66.    Egg  Gravy 

1      egg  Flour 

1%  cups  potato  water  Salt 

%  cup  milk  or  evaporated  milk  Celery  salt 

Scramble  egg,  chop  well,  add  potato  water,  seasoning, 
and  milk,    Number  of  servings,  6, 


RECIPES  313 

Calories  in  recipe  with  milk: 

Per  Cent         Per  Cent      Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

82  93  88  263  32  34*  33^ 

In  one  serving: 
14  15  15  44  32  34  34 

Calories  in  recipe  with  evaporated  milk: 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

97       134       112       343       28       39       33 
In  one  serving: 
16        22        19        57       28       39       33 

67.  Nut  Gravy  ("  Vegetarian  Cookbook,"  E.  G.  Fulton) 

1  pint  water  1  dessertspoon  peanut  butter 

1  cup   strained   tomato  Flour  as  necessary 

Emulsify  nut  butter  with  tomato,  add  the  water  and 
the  rest  of  the  tomato.  Thicken  with  flour.  Number  of 
servings,  6. 


WMWAAV0      J-JUL      ft  V^JLJ^W  • 

Protein              Fat          Carbohydrate 
37                      69                    108 

Per  Cent  Per  Cent  Per  Cent 
Total  Protein  Fat  Carbo. 
214  17  32  51 

In  one  serving: 
6                  11                   18 

36                17                 32                 51 

68.  Brown  Sauce 

4  potatoes  or  the  parings  of  6        3  tablespoons  flour 

potatoes  Salt 

2  red  onions  Sage 

1  tomato  Juice  of  l/>  lemon 

Scrub  the  vegetables  thoroughly,  do  not  peel,  cut  up, 
and  cook  as  for  potato  soup  stock  (recipe  25).  Strain 
off  one  pint  (or  more)  of  the  broth  for  the  brown  sauce. 
(Use  the  remainder,  after  straining  through  a  colander, 
for  soup.)  Brown  the  flour  in  the  oven  or  in  a  dry  pan 
over  the  flame.  Rub  it  smooth  with  water  and  thicken 
the  vegetable  broth.  Add  the  juice  of  one-half  lemon,  a 
pinch  of  sage,  salt  to  taste.  Other  vegetable  broths  or 
simply  potato  water  may  be  used  in  the  preparation  of 


314  THE    HOME    DIETITIAN 

this  gravy.     The  addition  of  a  little  cereal  coffee  will 
deepen  the  brown  color.     Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent         Per  Cent      Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

57       11       105       173       32        7       61 
In  one  serving: 

9        2        17        28       32        7       61 

69.  Tomato  Sauce 

1  pint   strained  tomatoes  1  tablespoon  minced  onion 

Flour  browned  as  in  recipe  68 

Cook    tomato    and    onion    together    twenty    minutes, 
strain,  thicken  with  the  browned  flour.     Season  with 
salt.     Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

33  59  142  234  14  25  61 

In  one  serving: 
5  10  24  39  14  25  61 

70.   Olive  Sauce 

12  ripe  olives  2  cups  brown  sauce 

Chop  olives  and  stew  slowly  two  or  three  hours.  Add 
to  brown  sauce.  Number  of  servings,  6. 

Calories  in  recipe: 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

52       214       135       401       13       54       33 
In  one  serving: 

9        36        22        67       13       54       33 

71.  Pea  Tomato  Sauce 

2  cups  green  pea  puree  1  cup  strained  tomato 

Add  the  strained  tomato  to  the  green  pea  puree,  and 
salt  to  taste.  Heat  and  serve.  A  little  browned  flour 
may  be  used  as  thickening  if  desired.  Number  of  serv- 
ings, 6  to  12. 


RECIPES  315 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

148  21  448  617  24  3  73 

In  one  serving  if  six  servings: 
25  3  75  103  24  3  73 

72.  Vegex  Gravy 

Add  Vegex  (see  note  under  recipe  39)  to  any  gravy 
in  the  proportion  of  one  teaspoon  Vegex  to  one  pint 
gravy. 

(F)      SALADS 

73.  Grape  Salad 

1      cup    white   grapes  1  egg 

y3  cup   blue   grapes  Marshmallows  as  desired 

1  cup  sliced  pineapple  %  cup  fruit  juice 

Seed  grapes,  and  remove  skins  from  white  grapes. 
Thicken  one-half  cup  fruit  juice  and  add  to  beaten  egg 
and  pour  over  grapes  and  pineapple.  Section  marsh- 
mallows  and  add  to  salad  just  before  serving.  Number 
of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

31  65  229  325  9  20  71 

In  one  serving: 

5  11  38  54  9  20  71 

74.    Fruit   Salad 

2  apples  2  bananas 

3  oranges  1  small  can  pineapple 

y2  cup  chopped  nuts 

Cut  up  the  fruit  and  mix,  together  with  the  chopped 
nuts.  Add  pineapple  juice,  which  will  serve  as  a  dress- 
ing (or  omit  pineapple  and  add  cream  dressing) .  Num- 
ber of  servings,  6. 


316  THE    HOME    DIETITIAN 

Calories  in  recipe: 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

75       397       615      1,087        7       42       51 
In  one  serving: 
13        66       102       181       7       42       51 

75.   Apple  and  Celery  Salad    ("  Manual  of  Recipes," 
Washington    Sanitarium) 

2      apples  Cream  dressing  or  golden 

y2  cup  celery  dressing 

Dice  apples,  chop  celery,  mix,  and  add  dressing. 
Number  of  servings,  6. 

Calories  in  recipe  without  dressing: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

4        11       120       135        4        9       87 
In  one  serving: 

1        2        20        23        4        9       87 

76.   Grapefruit  Salad 

Remove  pulp  from  grapefruit  and  cut  up.  Add  to  this 
diced  apples,  sliced  bananas,  raisins  or  shredded  dates, 
and  chopped  nuts.  Add  a  dressing  of  grapefruit  juice 
and  honey.  Replace  in  grapefruit  skins.  If  one  serving 
includes  grapefruit,  one  third  of  a  banana,  one  third  of 
an  apple,  ten  raisins,  three  walnuts,  and  one  teaspoon  of 
honey,  the  calories  in  each  will  be,  approximately: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

20  88  167  275  7  32  61 

77.  Carrot  and  Cottage  Cheese  Salad 

1      cup  ground  or  grated  %  cup  cottage  cheese 

carrots  Juice  1  large  lemon 

ys  cup  chopped  nuts  Salt  to  taste 

Mix  thoroughly.     Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

106      354       119       579       19       61       20 
In  one  serving: 
18       59       20       97       19       61       20 


RECIPES  317 

78.  Tomato  and  Lettuce  Salad 

3  tomatoes  1  large  head  lettuce 

Shred  the  lettuce  and  slice  the  tomatoes.    Arrange  in 
alternate  layers   in   salad   dish   and   cover   with   cream 
dressing  (see  recipes  87  and  88),  or  lemon  dressing  may 
be  used.    Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

40  487  174  701  6  69  25 

In  one  serving: 
7  81  29  117  6  69  25 

79.  Cabbage  Salad 

1  medium  cabbage  shredded.  Serve  with  cream  dress- 
ing. (See  recipes  87  and  88.)  Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

62       224       109       395       15       58       27 
In  one  serving: 
10        37       18        65       15       58       27 

SO.  String  Bean  Salad 

Let  two  cups  cooked  string  beans  stand  for  one  hour 
in  lemon  juice.  Drain  and  serve  with  French  salad 
dressing  or  mayonnaise.  Number  of  servings,  6.  Green 
peas  may  be  served  in  the  same  way. 

Calories  in  recipe  without  dressing: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

10  10  30  50  20  20  60 

In  one  serving: 

2  2  5  9  20  20  60 

81.    Italian  Salad    ("Food   and   Cookery,"   Anderson) 

1      cup  cooked   macaroni   cut          %  cup  finely  diced  raw  carrots 

into  small  rings  %  cup  cooked   green  peas 

1/2  cup   diced   celery  2     teaspoons  grated  onion 

Mayonnaise 


318  THE    HOME    DIETITIAN 

Mix  all  ingredients.  Season  with  lemon  dressing; 
serve  on  lettuce  leaf.  Number  of  servings,  6. 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

65        14       287       366       18        4       78 
In  one  serving: 
11        2        48        61       18        4       78 

82.  Raw  Vegetable  Salad 

Use  any  combination  of  raw  vegetables,  chopped  or 
cut  into  small  cubes.  Mix  with  mayonnaise  or  cream 
salad  dressing  or  lemon  juice  and  salt.  Any  or  all  of  the 
following  may  be  used :  Carrots,  turnips,  beets,  radishes, 
cabbage,  lettuce,  potatoes,  celery,  onions,  parsley,  cucum- 
ber, tomato. 

Calories  in  one  serving  (approximately)   without  dressing: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate         Total  Protein  Fat  Carbo. 

7  4  24  35  20  11  €9 

83.  Tomato  Jelly  ("  The  New  Cookery,"  Lenna  Frances 

Cooper) 

1  can  tomatoes  y2  cup  lemon  juice 

3  bay  leaves  y3  box  vegetable  gelatin 

1  medium  onion  (i/i  oz.) 

1  teaspoon  salt  1      cup  boiling  water 

2      tablespoons  sugar 

Put  the  tomatoes  with  the  seasoning  to  cook  until  re- 
duced one  third.  Then  rub  through  colander.  Prepare 
the  vegetable  gelatin  by  soaking  in  warm  water  about 
twenty  minutes,  draining,  and  cooking  eight  to  ten  min- 
utes in  one  cup  of  boiling  water.  When  cooked  and 
strained,  add  to  the  tomatoes,  turn  into  molds,  and  set 
in  a  cool  place.  The  jelly  may  be  cut  into  cubes  or 
other  shapes  if  desired  and  used  as  a  garnish,  or  may 
be  served  as  a  salad  with  mayonnaise  dressing.  Number 
of  servings,  12. 


Protein              Fat 

Carbohydrate 

Total 

Per  Cent 
Protein 

45                       17 

326 

388 

11 

In  one  serving: 

4                    1 

27 

32 

12 

RECIPES  319 

Calories  in  recipe  without  mayonnaise: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat  Carbo. 

4  85 

3  85 

84.    Cucumber  Jelly    ("The   New   Cookery,"   Lenna 
Frances  Cooper) 

1%  cups  cucumber  pulp  *4  cup  lemon  juice 

ys  package  vegetable  gelatin        1      cup  water 
(i/4  oz.)  %  teaspoon  salt 

A  few  drops  of  onion  juice 

To  prepare  the  cucumber  pulp,  peel  the  cucumbers  and 
grate  them;  strain  through  a  colander,  pressing  through 
as  much  liquid  as  possible;  add  the  lemon,  onion  juice, 
and  salt.  Prepare  the  vegetable  gelatin  as  for  tomato 
jelly  and  cook  in  one  cup  boiling  water  five  to  ten  min- 
utes. Strain  and  add  to  the  juices.  Turn  into  molds 
wet  with  cold  water  and  let  stand  until  firm.  Serve  in 
a  lettuce  leaf,  with  or  without  mayonnaise.  Number  of 
servings,  6. 

Calories  in  recipe  without  mayonnaise: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

7        4        53        64       11        6       83 
In  one  serving: 

1        1        8       10       11       6      83 

(G)     SALAD  DRESSINGS 

85.    Mayonnaise   Dressing 

2      egg  yolks  A  little  grated  onion 

Juice  of  1%  lemons  Olive  oil  or  salad  oil  as  needed 

(about  1  cup) 

The  ingredients  should  be  cold,  having  been  on  ice  if 
possible. 


320  THE    HOME    DIETITIAN 

Pour  oil  into  egg  yolks  very  slowly  at  first,  drop  by 
drop,  beating  constantly.  Keep  adding  oil  until  eggs  are 
very  stiff,  then  add  one  teaspoon  salt,  the  lemon  juice, 
and  grated  onion  or  onion  juice.  If  yolks  and  oil  sepa- 
rate, add  the  beaten  whites.  Otherwise  the  whites  need 
not  be  used  unless  desired. 

Calories  in  serving  of  heaping  teaspoon: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

50  .  .  50  .  .  100 

86.  French  Dressing 

2  teaspoons  lemon  juice  Salt 

2  tablespoons   olive   oil  Grated  onion  or  14  teaspoon 

onion  juice 

Number  of  servings,  8  or  one  teaspoon  each. 
Calories  per  teaspoon: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

34  . .  34  . .  100 

NOTE. —  This  dressing  is  very  nice  with  the  oil  omitted. 

87.  Cream  Dressing,  No.   1 

1/2  cup  evaporated   milk  14  teaspoon  salt 

1       teaspoon   sugar  1      lemon 

Beat  milk,  add  sugar,  salt,  then  lemon  juice.  Beat 
well.  Number  of  servings,  6. 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  F?t          Carbohydrate          Total  Protein  Fat  Carbo. 

31        87        82       200       15       44       41 
In  one  serving: 

5        15        14        34       15       44       41 

88.  Cream  Dressing,  No.  2 

^2  cup   thick   cream  Juice  of  2  lemons 

1       egg  yolk  1       teaspoon  sugar 

14   teaspoon  salt 

Boil  the  yolk  for  twenty  minutes,  or  until  quite  mealy. 
Break  up  with  a  fork  and  add  to  cream.  Press  through 


\_>€*AV/1  It/O       111       A  ^VIJJ 

Protein             Fat 

7                477 

v;  . 

Carbohydrate 

70 

Total 
554 

Per  Cent 
Protein 

1 

Per  Cent 
Fat 

86 

In  one  serving: 

1                 79 

12 

&2 

1 

86 

RECIPES  321 

a  fine  sieve.  Add  sugar  and  salt;  last  of  all,  add  the 
lemon  juice,  a  few  drops  at  a  time,  beating  the  cream 
with  a  fork.  If  the  cream  is  thin,  add  two  tablespoons 
evaporated  milk;  or  all  evaporated  milk  may  be  used 
instead  of  cream.  Number  of  servings,  6. 

Calories  in  recipe: 

-----        -.---..      Percent 

Carbo. 
13 

13 

89.  Golden  Dressing 

2      eggs  14   cup  light-colored  fruit 

*4  cup  sugar  juice  (orange,  apple, 

14  cup  lemon  juice  or  pineapple) 

Beat  the  eggs  slightly  to  blend,  but  not  until  foamy, 
and  add  fruit  juice,  lemon  juice,  and  sugar.  Stir  con- 
stantly in  a  double  boiler  until  it  begins  to  thicken.  Cool 
and  serve.  Number  of  servings,  6. 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

50  100  260  410  12  24%  63% 

In  one  serving: 

8  16  44  68  12  24%  63% 


(H)     DESSERTS 

90.  Cereal  Pudding 

1      cup  cooked  oatmeal  or  %  cup  Karo  sirup 

other  left-over  cereal  %  cup  nuts 

1  egg,  or  more  if  desired 

Put  all  together  in  a  double  boiler;  when  smooth,  turn 
into  an  oiled  pan  and  bake  three  fourths  of  an  hour. 
Serve  with  lemon  sauce.  Number  of  servings,  6. 

21 


322  THE    HOME    DIETITIAN 

Calories  in  recipe  without  sauce: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat         Carbohydrate         Total  Protein  Fat  Carbo. 

93      432       604     1,129       8       38       54 
In  one  serving: 
15       72       101       188       8       38       54 

91.   Lemon  Sauce    ("Vegetarian  Cookbook,"   E.   G. 

Fulton) 

1  cup  sugar  1      lemon 

1  egg  %  cup  boiling  water 

Put  grated  rind  and  the  juice  of  lemon  with  the  sugar; 
add  the  beaten  egg;  add  the  boiling  water  just  before 
serving.  Cook  slowly;  do  not  boil.  Number  of  serv- 
ings, 6. 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate         Total  Protein  Fat  Carbo. 

25       50       855       930       3        5       92 
In  one  serving: 

4        8       143       155        3        5       92 

92.  Farina  Mold   ("  Manual  of  Recipes/'  Washington 

Sanitarium) 

4  cups  water  %  cup  sugar 

1  cup  farina  or  cream  of  Pinch  of  salt 

wheat  Flavoring  as   desired 

Cook  farina  one  hour  in  double  boiler,  add  sugar,  salt, 
and  flavoring.  Pour  into  molds,  chill,  serve  with  fruit 
juice.  Number  of  servings,  6. 


V^arlVfJ.  **5O      J.JJ.       AW»£TV« 

Protein             Fat          Carbohydrate         Total 
57                  17                820                894 

Per  Cent        Per  Cent     Per  Cent 
Protein              Fat              Carbo. 

6                     2                   92 

In 
I 

one  serving: 
1                   3               137               149 

6                   2                92 

93.   Fruit  Sauce 

cup  red  fruit  juice  %  cup  lemon  juice 

cup  sugar  Cornstarch 


RECIPES  323 

Heat  fruit  juice  and  lemon  together,  add  sugar,  and 
thicken  with  cornstarch.     Number  of  servings,  6. 
Calories  in  recipe: 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

520  520  . .  .  .  100 

In  one  serving: 

87  87  . .  . .  100 

94.  Cornstarch  Pudding   (without  milk) 

1  quart  water  1  cup  sugar 
o  tablespoons  cornstarch                  3  eggs 

Salt  Flavoring  as  desired 

Put  one  quart  of  boiling  water  in  double  boiler,  add 
the  cornstarch  rubbed  smooth.  Salt  to  taste.  Cook  until 
clear.  Add  sugar,  remove  from  fire,  beat  in  quickly  the 
well-beaten  yolk,  add  the  whites  beaten  stiff.  Beat  well, 
add  flavoring.  Number  of  servings,  12. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

75       150       954      1,179        6       12       82 
In  one  serving: 

6        12       80        98        6       12       82 

95.   Stuffed   Prunes 

Wash  thoroughly,  remove  pit.  Put  in  place  of  pit  an 
almond  or  one  half  a  walnut.  Roll  in  powdered  sugar 
if  desired. 

Calories  in  one  prune  if  large: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

3  13  25  41  7  32  61 

96.  Prune  Whip 

2  cups  prune  puree  1  tablespoon  sugar,  or  as 
2      eggs  desired 

%  cup  nuts  Flavoring  as  desired 

Add  the  yolks  and  nuts  to  the  prune  puree,  flavor,  and 
sweeten,  stir  well,  then  fold  in  the  beaten  whites  of  the 


324 


THE    HOME    DIETITIAN 


eggs,  reserving  enough  of  the  latter  with  which  to  gar- 
nish.    Number  of  servings,  10. 
Calories  in  recipe: 

Protein  Fat         Carbohydrate         Total 

111  498  621  1,230 

In  one  serving: 
11  50  62  123 

Calories  in  recipe  if  nuts  are  omitted 

Protein  Fat          Carbohydrate 

63  . .  587 

In  one  serving : 

6  59  65  10  90 


Total 
650 


Per  Cent 
Protein 

8 


8 


Per  Cent 
Protein 

10 


Per  Cent 
Fat 

41 


41 


Per  Cent 
Fat 


Per  Cent 
Carbo. 

51 


51 


Per  Cent 
Carbo. 

90 


97.   Strawberry   Fluff    ("Vegetarian   Cookbook/' 
E.  G.  Fulton) 

2  egg  whites  1  pint  strawberries 

%  cup  sugar 

Mash  strawberries  with  the  sugar  and  add  to  the  un- 
beaten whites.    Beat  until  light  and  foamy.    Number  of 
servings,  6. 
Calories  in  recipe: 

Protein  Fat          Carbohydrate         Total 

64  20  734  818 

In  one  serving: 
11  3  122  136  8  2  90 


Per  Cent 
Protein 

8 


Per  Cent     Per  Cent 
Fat  Carbo. 

2  90 


98.  Banana  Snow  ("  Food  and  Cookery,"  Anderson) 

y2  cup  banana  pulp  2      teaspoons  lemon  juice 

1      tablespoon  sugar  or  honey      A  few  drops  vanilla 
1  egg  white 

Mix  and  beat  with  wire  egg  whip  until  very  light. 
Put  on  a  sauce  dish.    Garnish  with  red  strawberries  or 
jelly.     Number  of  servings,  2. 
Calories  in  recipe: 

Protein              Fat  Carbohydrate  Total 

30                    5                148  183 
In  one  serving: 

15                    2y2              74  91  16                  3                81 


Per  Cent 

Protein 

16 


Per  Cent     Per  Cent 
Fat  Carbo. 

3  81 


RECIPES  325 

99.  Vegetable  Gelatin   (Agar-agar) 

How  to  prepare  vegetable  jelly :  Soak  one  ounce  vege- 
table gelatin  in  warm  water  for  an  hour.  Drain  and 
add  to  one  quart  of  boiling  water.  Let  boil  about  ten 
minutes,  or  until  clear.  Strain  through  a  cheesecloth, 
and  it  is  ready  to  use.  It  is  much  to  be  preferred  to 
animal  gelatin. 

100.  Orange  Jelly  ("  Food  and  Cookery/'  Anderson) 

1*4  cups  orange  juice  3  tablespoons  lemon  juice 

\'-A  cup  water  1  cup  vegetable  jelly    (see 

y2  cup  sugar  above) 

Mix  all  cold  ingredients,  and  add  the  vegetable  jelly. 
Mix  well  and  pour  into  molds.  Add  a  few  thin  slices 
of  orange.  When  cold,  serve  with  a  little  red  fruit  juice 
around  each  mold.  Number  of  servings,  6. 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

585  585  ..  ..  100 

In  one  serving: 

97  97  ..  ..  100 

101.   Fruit  Mold 

1%  cups  berry  or  other  fruit        3  tablespoons  lemon  juice 
juice,  sweetened  to  taste      1  cup  vegetable  jelly 

Mix  and  pour  into  molds  immediately.  Number  of 
servings,  6. 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate         Total  Protein  Fat  Carbo. 

355  355  ..  ..  100 

In  one  serving: 

59  59  . .  . .  100 

NOTE. —  Nuts,  sliced  fruit,  raisins,  etc.,  may  be  added 
to  this  recipe,  making  a  very  delightful  variation. 


326  THE    HOME    DIETITIAN 

102.  Cake  Without  Baking  Powder 

4  eggs  1  cup  sifted  flour 

1  cup  sugar  1  teaspoon    lemon   juice 

Pinch  of  salt 

Separate  eggs,  add  one  half  of  the  sugar  to  the  yolks, 
lemon  juice,  and  salt.  Beat  until  foamy  and  the  sugar 
is  dissolved.  Then  beat  whites  until  stiff  and  add  the 
other  half  of  the  sugar  to  the  whites.  Beat,  add  the  yolk 
mixture  to  the  white  mixture,  folding  them  into  each 
other.  Then  fold  in  the  flour  very  carefully.  Bake 
twenty  minutes  in  a  slow  oven.  Number  of  servings,  16. 

Calories  in  recipe: 

Per  Cent         Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

163       215      1,280      1,658       10       13       77 
In  one  serving: 

10  13        80       103       10       13       77 

NOTE. —  The  above  may  be  used  as  a  basis  for  nut  or 
layer  cake. 

103.  Cake  Without  Sugar 

1  cup  pitted  dates  1      cup  zwieback  crumbs 

1  cup  shelled  walnuts  */»  cup  water 

Put  the  dates,  walnuts,  and  crumbs  through  a  food 
grinder,  add  the  water,  mix  thoroughly  and  press  firmly 
into  a  pan.    Let  it  stand  twelve  hours.    Slice  and  serve. 
Number  of  servings,  12. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

131       822       897      1,850        7       44       49 

In  one  serving: 

11  68        75       154        7       44       49 

104.  Hot  Malted  Nuts 

Place  two  tablespoons  malted  nuts  in  a  cup,  add  slowly 
boiling  water,  stirring  well.  Serve. 


RECIPES  327 

Calories  in  one  cup: 

Per  Cent        Per  Cent     Per  Cent 
Protehi  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

27  73  50  150  18  49  33 

105.  Peanut  Milk 

1  tablespoon  peanut  butter  %  teaspoon  honey 

Emulsify  peanut  butter,  adding  water  gradually  up  to 
6  ounces.  As  the  water  is  being  added,  stir  in  the  honey. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

17  62  18  97  18  64  18 

106.  Cocoanut  Drop  Cakes 

2  egg  whites  J/&  cup  shredded  cocoanut 
%  cup  sugar  2%  cups  corn  flakes 

Add  salt  to  egg  whites  and  beat  stiff.  Add  sugar  grad- 
ually, beating  well.  Then  carefully  fold  in  the  corn 
flakes  and  the  cocoanut.  Drop  from  a  spoon  onto  oiled 
pan  and  bake  one-half  hour  in  a  slow  oven.  Number  of 
drop  cakes,  10. 
Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate         Total  Protein  Fat  Carbo. 

142  290  1,144  1,576  9  18  73 

In  one  drop  cake: 
14  29  114  157  9  18  73 

107.  Caramel  Pudding  (Mrs.  W.  D.  Gibson,  of 
Pasadena   Study   Club) 

2  cups  brown  sugar  %  cup  nuts 

2  cups  water  Pinch  of  salt 

2  tablespoons  cornstarch  1      teaspoon   vanilla 

Add  sugar  to  water,  boil  five  minutes,  and  thicken 
with  cornstarch.  When  thick,  add  nuts  and  pour  into 
molds  to  cool.  Serve  with  whipped  cream  or  any  other 
pudding  sauce  desired.  Number  of  servings,  10. 


328  THE    HOME    DIETITIAN 

Calories  in  recipe: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate         Total  Protein  Fat  Carbo. 

53       465       966      1,484        4       31       65 
In  one  serving: 

5  40       97       148       4       31       65 

108.  Baked  Bananas 

Select  ripe,  firm  bananas.  Bake  in  the  skins  in  a  slow 
oven  until  tender.  May  be  used  as  a  vegetable. 

Calories: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

6  7  123  136  4  5  91 

109.  Banana  Croquettes 

Peel  and  scrape  the  banana ;  roll  in  an  egg,  beaten  and 
mixed  with  four  tablespoons  of  milk.  Then  roll  in  sifted 
bread  crumbs.  Brown  in  skillet  or  bake  in  oven.  May 
be  served  as  a  vegetable. 

Calories: 

Per  Cent        Per  Cent     Per  Cent 
Protein  Fat          Carbohydrate          Total  .   Protein  Fat  Carbo. 

12  18  120  150  8  12  80 

110.  Fruit  Eggnog 

1  egg  3/{;  glass   (or  more)    of  straw- 

berry or  other  fruit  juice 

Beat  egg  separately.  Carefully  fold  the  fruit  juice 
into  the  white,  then  fold  in  the  yolk,  and  cap  with  a 
strawberry  or  bit  of  jelly. 

Calories  in  one  eggnog:  perCent      perCent    perCent 

Protein  Fat          Carbohydrate          Total  Protein  Fat  Carbo. 

25  50  30  105  24  48  28 


APPENDIX 


329 


§    ° 

UJ 
UJ 

i, 

<     w 

UJ        % 

ti    U 

U,      13 

o    § 

S  4 

*  ! 

>    M 


DO^^^^^^O 
M     r-l     iH  rH     rH 


O     CO    T-l    iH     iH     iH 


& 


J"3    CO    i-t    rH    T-! 


iis  *..... .»» «*»* 

dllgIaa*|S||ij**Aj|jj 

^4^(M<M(M(MC<l<M 


I 

bfl 


S 

^a   cs 


of  the  food  values  in  Tables  I  and  II.  reference  has  been  made  to  nment  Bulletin  No.  28. 
n  Foods  ;  "  to  the  Battle  Creek  Sanitarium  Diet  List  ;  to  Pattee's  "  ical  Dietetics  ;  andto 
sonal  work  in  weighing  and  measuring  has  also  been  done.  The  v  in  Table  I  are  for  foods 
except  in  the  case  of  cooked  vegetables  ;  the  value  of  each  of  these  computed  for  the  veg- 
ition  of  milk,  cream,  or  fat  of  any  kind.  The  housewife  may  easily  estimate  the  caloric  value 
The  percentages  given  are  of  the  total  food  value  and  not  of  the  weight.  Obviously,  from  the 
these  figures  cannot  be  absolutely  accurate,  but  their  approximation  is  sufficiently  close  to 
s  and  decimals  have  been,  for  the  most  part,  disregarded. 


i 

-t-oO-^t-^' 


ill 


i 
A 


lu" 

KUllI 
JlJrin 

fPHsis 

IrvKMvi 

ssl$iil! 

*?•  IilS* 

3!'- 18*!= 


b 
any 
ry  n 


"  C 
Loc 
as  ord 
etable 
of  an 
ve 
se 


330 


THE    HOME    DIETITIAN 


"c 

•>  * 

o' 
^ 

,,-• 

24* 

OO    00 

2?  5 

00    00    t- 

05    05 

Oft    05 

00    00 

O5    OO 

OO    00    OO                               • 

LO 

si 

$5 

g 

**t*    0} 

CO     r-l 

oo  o 

rH    ^ 

CO 

O    TH     Oft 

OO    OO 

01     OS 

LO    -^ 

<M     CO     <M 

^c 

^ 

0    5 

OO    OO 
00    rH 

<M      •<*! 

05    00 

OO    O5     LO 
LO    <£•    t- 

O    CO 

O*     LO 

00    LO 
CM    CO 

s§ 

LO    O 

0     05    rH                           ^ 
LO     -«t*    O                           rH 

i 

H 

?! 

M    rH 

0    CO 

0    Oft    0 

t-    00 

<M    rH 

b-     rH     r^ 

LO 

< 
C 

?£ 

1 

TH 

<M    C<1 

TH 

ss 

LO    <M 

co 

C<1    CO    LO 

rH    TH 

TH 

rH 

LO     CO 

<M    rH    CO                         •* 

T-* 
,_              J 

00 

1 

TH     rH 

TH     Cxi 

rH 

rH 

rH 

CO      TH 

rH 

a 

C<J 

Weight 

N      X 

O     O 

rH    CO 

§      § 

LO     tO 

§      § 

LO     CO 

§     §     § 
^Ct" 

CO                  TtH 

§      § 

H 

!! 

CO    " 

§    § 

Tf     iH 

§      § 

N       X      SJ          £              * 

O     O     O          £           C 

rf?   ^    ^         Q             rV 

CO            CO 

!« 

£ 

a 

a  a  a 

"/.        7-       '/. 

a  a 

IS 

a  a 

02      32 

•£.   £} 

a  a  a               - 

.Q    5    S                  g    J 

-  >' 

IM 

0> 

3 

5  8 

a  a 

o      • 

0 

co  -2 

3  g 

(M    r-l 

0     0 

o    a 

a  a  a 
&  A  A 

<M    <M    <M 

QQ   a 

2  ** 

a  a 

~  ~ 

IM   oq 

ft   .2 
<M    rH 

a  a 

a  a  n          "8   > 

^   ^  tf             A  J9 

<5<1    C<1    <M                 rH    r- 

1 

03 

^ 

3 

8 

± 

.        .        . 

^ 

$   : 

CJ     ° 

o 

fe      «2 

3 

"^ 

• 

• 

0     "•= 

* 

Q 

I 

O       03 
OQ      2 

*  1 

I,  cracked 
I,  gluten  . 

,  oatmeal 
ny  

03        1 
WJ     OQ 

fl     ^      ^ 

?  * 

II 

polished 
puffed  . 

a  1 
II 

« 

1 

a 

S    2? 

8  3  2 

s-<  cs  ?_ 

«  «   So 

SM 

32 

Q)     O 

3     S3 

o>   a 

s  5 

§N 

m      O 
0     0 

8  i 

O     C^ 

o    ~ 

g  g  g               * 

A  ^  A               t: 

0  0 

O  O 

Offi 

ffi  W  0 

tf  tf 

#  # 

5  S 

H  ^ 

^  ^  ^               ff 

« 

APPENDIX 


331 


CO    <0    "f    10 


g   CM  IO    •  TH  TH  CO  CM    •  IO  «C  •»**  «O 
TH  •  ••*  CO  CO  CO 


£   *l  00  -*  O  W  10  <•* 

N-.lt—  CO  1C  lO  O5  CM  1O 


10 

t-OO^OCMCSTHOOTH-f 
IO    t-    TH    TH    t-    OO  "*•    "*> 


-C 

£ 

1 


NNNNNNtQNNtaNN      +*   N   N   N   S3   N   N   N   N*   N   X 

OOOOOOOOOOOO      («   OOOOOOOOOO 


•      0)      CQ 

5-  M  « 


U=glS5«»i|sg 


THC.'SCiOCOCO^O^COM' 


'co'Ma)a)a)a>a)Qj 
TH    ?H     08    48    tf    €0    C0    08 


K 


fl  S 

fe-  *> 

l>  L>. 

02  a 


a* 


5 


S   -5 
2| 


O  U 


—    JC 

O  O 


|  a  1 1 

^  M  *  ^j 

.jT  _jj-  .>"  3 

—  bJC 

5  S  5  (M 


3:S 


S3    fl 


OJ     <U     <£ 

ffl  PQ  « 


^   «  <»  o   5   5J 

«    co  co  3   ^j   ^    ;; 

«   *S  'S  '3    «   ^    | 

"     W  •  «  0X3X5^ 

CQ  CQ  CQ  O  O  O 


332 


THE    HOME   DIETITIAN 


u-f  ,| !  .   .   .   i   .   i   .   i   .   .   i   .   i   i   :   :   i   :   :       Jo  ^  ^  ^ 

*« 

.s 

^o2 

£}rHCOr-lr-lr-lr-ie<lr-lrH  rHC<I  rHr-l  iH    r-l    iH  °    r-l    rH 

•  •••••••••«•••••«  ^     ^q     ^    j^j 

TH      -**00      O 

/  M 

A) 

lOlOlOT-tiHCOOOC^OOlOOCO'^THrHOOlO          SfOMlOOO 

<M  iHiHi-i  iH  rHrHrH  E 

•|-atga    ttgJg    a-,.,,..!.,^ 

,-1  '     ' 

_Q 

x^l  \M        ^*  v^    v^l 

bfi        . 

•J       '-.'•-'       ^'       'J      t,'      tn*      fcl       S^       U.'       1.'       tJ       t;'      (H*      ^       'J       'J       •„'       %.'  ^      ft     ft     & 

>->>^>>>.>.>.>.>>.>.>a2>>>>  ^^  * 

73       ....    73       

;;;;;;  ^j    *     '    I    '  ,2    '    I    '     *    '     '    ; 

•  -oiTsn^-'ObJD'         B   Q  > 

'£H*3W)'''C<,2  J2^H.S«3 

llliiili'llilllfiili    S-IH 

o91£3l2e8ei3«JciJ.So5i2>>aJcerd£3<D  ajaiOJOJ 

QawffiffiffijjjH3sSoa}^SHH>       <:««« 


APPENDIX 


333 


p 


TH-*THOCO<MCOrHTH 


wt-ooos 

t>    «5    O    TH    <M 


§oO(Nt-<e>THoo>ot~oo 
O    TH    TH    «O  CO     •"*<  OlrtOO 


o  t-  t-  to  TH  co  oo  rH  o  c-i  "*  oc  i-  t-  oo  oc  -<t<  <M  M  t-  o  TH  o>  o> 

Ifl     •**     M  C-l     TH  TH  TH     t-    t-  •»*<  rH     CO  t-    ^     00     OC 


10  10 

iHtH  COOOr-l<MesiTHTH 


TH    t-    O    TH    00    if    O    O 


00    if    O    O 
<M    rH    TH    TH 


£ 


ii 

OOOO 


&  I- 

V  F^     O 

03      «•>••-»      QD      J> 

OJD 


a  ci< 


addftdddci.ci.n5   dec   (-'2    d 


gg|g5sjg'^a€>pi»»b 

>  5>   "^     C  >• 

rOCOr-l      rtrHiM     C8CO      OCOCOM      Cl! 


| 

1  * 

*  s 


IH 

a   oo    oo 


is 


§  a  § 


•lii 

Isl, 


I  g 


.    .    :    .    .    .  x  . 

::::::§  :  •§ 

:  :      :  :  :  *  :  I 

:   :  |   :   •  f  |  a 

*J                            •         *  .    M    V«  0  _* 


IsallllSIlfill! 


5  5 


384 


THE    HOME    DIETITIAN 


Oi    TH    CO    <M     O    O 


Slip 

S  i 

Tl'c'JiiOiSDOqiOOOrHOO 
^g.  ^00  ^^rH 


U5 
t-    -* 


I  ea   CO  C4 

!   O     O     rH 


t-    t-    iH    rH    CO    <M 


rH     O    «O         •     U5 


Tt<      O      CO'      CO      !M      T—t 


1 

i 


CO     ^     CO     CO     CO     TH     L-     U5     r-|     CO     U5     CO 


NOSN^SNXXNXNXSIN: 

OWOO-— 'OOOOOOQOOC 

CO    ^    CO    M  OO    <M    rH    rH    OO    W    rH    M     t£     Ct 


CO    CO    iM    CO    Ot    Ifl    ^    C<I 


a  a  c   a  ft 


>TB  . 

&  §  S  a 


(M      OS 


a^^ 


|| 

i  i 


§8    2   ^   ^a 
Q    ^     c>    A 

+>    *j    to    cS    2 

5  5  S  .S  -I  a  c  sc 

O     O     *     ft    C*  'O    -53     * 
CLpHtfTOOJHH^ 


iiips 
etable 


«     C     fc     g1  & 

OJ     a>   «9     O     QJ^     x,,^ 

Vr.      J*l     -*J     i— i       r«*J       O-4J 


OJ     <J?     GJ    »*5 

5SS«^S«^ 


^^"^^3     <D     0)     0> 
S   rH    <M      Ctf      03      C« 


5   « 
ft  '— 

ft  ft 
<  < 


t 
a 


<&  <--; 

CG    nQ 


:||1 

lssa 

CB   iCl     —    — 

O  O  O  ps, 


fc  *3    •  & 
o  C        -^ 

S    <S     05     ® 

II  II 
o   ^   t-i  .^. 

O-O  O  M 


0    0-: 


APPENDIX 


335 


*i^ 

IO 

S 

o; 

00 

•f    t-    CO    CO    00 
05    t-    05    t-    00 

O5    O    OO    CP    00 
00    05    05    05    00 

05 

§ 

05 

TH 

i 

i 

oT  £ 

&  * 

IO 

iii 

t- 

CO 

•    CO        •    CO    CO 

•    rH        •    TH 

•^»    OO    rH        -00 

* 

: 

* 

00 

C£ 

CO        • 

ilj 

- 

>. 

CO    O    t*»    O    CO 
rH             rH 

co"  co  co  T»<  -<f 

r-' 

: 

CO 

CO        • 

CO 

* 

rH    rH 

^ 

g 

t- 

T-! 

O5    CO    CO    O    O 
CO    CO    CO    CO    00 

CO    CO*    ^    IO    O 
CO    CO    IO    CO    IO 

11 

K 

0 

l>    0 

co  to 

„ 

S 

§§ 

H 

H 

rH    rH 

w 

o*» 

•g 

II 

S 

US 

r- 

t-    b-    O    OO    O 
CO     CO    00     CO    t- 

0^0-*^ 
CO    CO     IO     CO     •*             „ 

J 

00 

T— 

H 

i- 

rH 

o: 

CO    0 

co  to 

8 

0 

',£> 

CO    05 

^t*  <y$ 

rH 

^ 

CO 

rH 

.  tt      .  ^  ,0 

rH    C-1    rH        •    -f        JZ 

10 

•^ 

•     ; 

CO 

« 

00       ; 

c 

"5    «o   io                         U 

1 

•^ 

^ 

CO    -^    CO    CO    10 

•^      rH              J2     rH     CO          S 

CO 

• 

CO 

"*     ! 

*"* 

CO 

rH    rH 

X 

§ 

S 

'§§§§§ 

3        N      N      N      N      N        ,** 

g    ooooo     tu 

X 

O 

b 

0 

§  8 

§ 

X 

o 

N      X 

0     Q 

'3 

j|S 

1^       *x^    "^    ^^    v^O    v^l 

P 

f 

ri 

rH    CO    CO    CO    O 
rH 

j3 

<*< 

CO 

•* 

CO    CO 

CO 

rl 

00     rH 

a  ft  a 

2 

a 

a 

a 

a 

a  a 

V 

as 

u. 

cc 

JS 

* 

3 

n? 

8 

S  *t  *!  *!  S 

•B 

t£ 

CO 

**     OB 

E 

OJ 

> 

"^ 

2   a  g  a  = 

1)     0>     0>     0>     rj          ^ 

fl  c  c  s  S     ^ 

Tc 

J3 

a  4S 

43   fee 

a 

a 

a  a 

cD 

M 

C8    CO     CO    CO     rH 

oooo-2      5 

:  :  :  :  :  35 

rH 

rH 

iM 

CO    rH 

CO 

CO     rH 

£ 

rt    TJ        •        ' 

.      .      .      .      . 

. 

. 

•     0) 

g 

-—            (^                 •                 • 

* 

*  »s* 

s 

• 

pQ          $M 

S 

_ 

••     X 

~ 

O     *r™> 

03    >> 

oT   cc    o>    C 

O> 

OJ 

2 

^> 

q>    0)   •-     o 

^ 

T- 

O 

^-. 

_* 

.    "3 

1 

I 

Pineapple 

3    2    ^    t.    C3 

H,  «  («  w  £ 

1  »    !  8  1 
II  |11 

<  Q  fc  d,  tf 

CS 

"a 

"a 
a 

3 

0) 

"ft 
a 

Apricot  s« 
Blackberr 

Blackberr 

S 

X 

u 
-_ 
0> 
£ 
0 

Cranberry 
Currant  j 

336 


THE    HOME   DIETITIAN 


0)2*      OOOCSOLOOTfOOt-O 
U'S.g       OOOOSOOsOosOOasO 

05 

§ 

OS 

o 

0 

CO 
OS 

TH     00 
t-    IO 

rH     rH     rH 

t-  t-  t- 

OO 

Sets       .,...TH.^--TH- 

C3 

C<l     LO 

£££    

c 

**  "**  *5            •         •               rH               •«*<         -CM         •         -CM 

°rW 

"3      LOLOOOOOOOOOOO 
•g       00             CSONCOLOLOL»t~OLO 

CO 

0 

LC 

o 

0 

<M    CO 
t-     t- 

0    0 
IO    CO 

(M    (M    CN| 

co  co   to 

iH    (M    O 

t-    TH    <M 

CO 

TH 

0 

&J 

.Q  g       LOLOOOSOt^Ot-OOt-O 
Jj,g       OO             OJOS<MlOLO^t»t-OSLO 

s 

Cvl 

0 
<M 

OO 

t-    CO 
t-    CO 

CO    0    CO 

TH     LO     LO 

0 
LC 

*J    ;       TH        •    <M        '        •     rH        • 

rH 

LO     CXI 

«*<    00    0 

on 

£    •       

C 
^         •  ••.-•   .f-1       •   «i     .•    t"l  '••-.•   O«       • 

+2     NMNfeaMta^GaHNNta 

•g     oooooooooooo 

*3>          NS\                                              ^^J 

p£     co          coTHCOcicoc^coiMe<jco 

CO 

s 

<M 

§ 

(M 

s: 

0 

C-1 

b 

rH 

§ 
<M 

1 

HB 

§ 

f 

Q 

LO    00 
00     LO 

N      N 

0     0 

Si  M 

xf     -*<     LO 
rH    •*     •* 

TH      TH      TH 

o    o   b 

TH    <M    <N 

(M 

H 

tsi 

0 

CO 

a        a        a        a  a 

g" 

£ 

S4 

>    > 

>     >     > 

> 

^j     1                                          .O                   fO                   pO                   r^      pO 

J 

£ 

aj    a> 

<D      Q)      O 

y 

tOQ     ^      OQ                        QQ 

CO      03 

^            „     Sl)^rc5<rgl) 

5 

T£ 

S 

7£ 

S 

£  £ 

II  > 

^ 

•  • 

03      O3      03 

o3 

• 

• 

:::::::::::  % 

0 

1 

t-, 

'  -  8 

es 

t; 

T3 

a> 

:    :    :  «    :    :    :    :    :    :  «  s 

ft 

^ 

s 

03 

T3 

08                                                                    rrt          - 

* 

^ 

* 

9? 

*™^ 

OS 

:::-s::::::rtg 

£ 

a> 

ft 

53 

a 

8 

^_ 

2    55 

flj      P        •                  ....      CO      ^ 

•  9   o  a         a>     •                    S  *r-> 

liifiliiiiij! 

"S   §gSS^^-«^2«l 

I 
b 

0) 
/•} 

'$ 

•r-s 

>» 

1 

1 

fc 

=3 
•r-s 

b 

a> 
& 

fv 

5 

CQ 

>i 

^ 

X5 

chocolat 
coffee  . 

•    T3    ^ 
O     QJ 

6  !•§ 

£ 
j^ 

S 

Sflo'g'S^^aESft 

C3Mo3c3c3c3c3ctSE3E3P 

W       O       C       M       W       V       9       O      r~*      »"^      '  ^H        ^ 

n 

ft 
3 

ti 

ft 
cc 

s 

OJ 
t- 
4_> 

02 

I? 
03 

t- 
_ 

02 

O>     0) 

"c8    ec 
0  0 

Ill 

o> 

1 

APPENDIX 


337 


I- 


I! 


"*U5   •   •  O  <M  <N  00   •  CO  CO  «  0>  N  Ift  O  <M  00 
<M  -*<   •   •  irt  U5  T-H  00   -CO     CO  CO  -<t<  CO  <M  r-l  Tf 


O    r-l    O5    l~    t— 


(MCOi.trSOCMJfOOLOOOOOi-IOOOOOOOOCi 
rHiHi-l  "        <M     iH  (M     iH     iH     TH  CO<M<MOO<M^t<lMMTH 


CO  CO  ^  rH  l>  f  OO  O>  LO  IO  -f  00  i-H  QO  O  IO  OS  ^  O 


co   co 


i 


QO    <M    CO        •    M*    O    -ti    CO    IO    O    O 
t-    iH    CO        •THOOOCOO'Jf^ 


1 

i 

g 

X      X       X      S      X      X       X 

0     O     O     O     C     O     O 

X       X       X       X       X       X 

O    O    O    o    O    O 

x^j    x^J 

§  § 

XXX 

0     O    O 

X 

O 

§  §  § 

§ 

"c 

0) 

• 

t   *              5T 
a>  .i              j2 

M   *         ^  *- 

C               J? 

"/.                                    — 

X        -      ^      a> 

0> 

.2    <u   .2 

ID 

d  > 

M      fc. 

0}    *•*     w 

a 

OQ 

1 

1 

^   ^        J2   a 
«    c.        5^: 

§  5  £  g  £ 

a 

»i    ft 
-      .     - 

a 
- 

*^l 

^  w    rt 

a 

^= 

:   :  ^    :   :   :   : 

ial  :  :  :  : 

:    •  m 

'      rf     W 

v  a         '  ^     ' 

*     cd     & 

I 

-i-J 

a 
aT 

*£  *  *       :  fc  M 
o  «  «        -5 

S*  «   «       -o  °°   § 

1   :  a   :  8.  S 
S      2^5  § 

K^      f-l       O                   f-i 

-*-*    O    o    _M     L>>    nJ 

0) 

W     rv 

x     OS 
Ctf 

custard 
lemon  . 
mince  . 

pumpkil 

•1  2 
.2 

'«   be  be 

'J3   c   c 

&c 

c 

-r 

S 

o  u  u  o  o  O  Q 

^  o   o>   S  es  rt 

fc  S  £  ^  _:  ?; 

~  £ 

E  S  E 

£ 

of  'S  "2 
£  —  — 

£ 

22 


338                                 THE  HOME    DIETITIAN 

J.£  1 

jjjrt^Oi^OOOOO  CO^OCiOCTft-t—    t-                      -fl   (55    rH    t— 

•S4J      lOt-OSOOOOO  t-    rH                     rH                                        4)   CO    t-    CO 

«<3.C  ? 

fU  *^ 

s 

r  C  ti    |  OO    OO <M    CO    O    OO    CO    Tf    CO    OO    CO                        6C  OO    IO    OO 

(SJrtfi   I  W    ^ OOOOCqt-OOC-COoOOO                      3^rH^ 

C  * 

i;'c'5|ooooco iooocoo5<NOioc                c'oo-^io 

£  4>  O    jrH  rHrHrH                     <M<MrH                        SJrHTHrH 

PL,  t< 

—    :  O 

WlOOOOOlOlO  ClOOOlOOOooO                          .OOrHO 

t-t-OO-^COONlM  t-OlOOt^OCO(MO                      ^COOSCO 

rH                                     rH  rH    rH            (M            rH    rH    iM    CO                      S   rfi 

£ 
I 

rHOJlOOOOtOtO  CO'flOt-COttiiMCOO                      CoiOO 

OikOt-Tt*COO<M(M  COCO                     iMrH<M                       ^t^COTf 

! 

t-O COCOOCON-TfiMaiO                       .2   O    ^f*    rH 

llOrH ^OOrHlOCOt-0005l«                        ^(JSrHr-i 

rH  rH  rH    N  3   rH 

S 

•^COkO t-OlOt-t-C^COCiOO           g       ,OoO<Ni35 

Cq                        (MrH                             (MCCIr-iCO            J             t-    rH 

Z  1) 

NNMNNNtaM  S     fi     M    N     S    19     N'     S     N          S      S     S     ll     N 

•COOOOGOOO  ooooooooo   ,2°oc 

^CO<M<M                     rH  rH             rHrH                     rHrHrH1     '^OrtiOO 

ft     ft             ft  ft     ft     ft 

OQ      CD               CO               -i  CO      CC      CC 

X2    ,0       ^    ,0             g  X2    -2    ,0 


ftG>§ft3'5a» 
X«    »G    -*_>    .C     O     ^    -4^    +j 

C  O  O'OOIOOO 

(M<M<MrHrHaQrHrH  rHCOrH        'rHOOrHrHrH 


CJ    ,ig    ,C3    Jc! 
rH    (N    <M    rH 


O 


TO 

«     S     a, 

i?isi 

fcs  a  2  g 


SB 

^  5 
S  ^  ^ 

Isli 

T3     S     0)     bfi    wu    ou    i 
3     ««    X5     S     S     S    £    .t 
feCXiCCCQCQCQC/35/2 


ft    ft 


00  *f      '    S 

1  §|    g|     »| 
I  11    •111 

1  8  a  S  1  I  5 

O  O  fe   &,  d,   CU   ^ 


l! 

o  *5 

^  « 


11- 

•a -as 
sill 

to    o    u  £ 
o    03    rt    ee 

3  S  S  E 


APPENDIX 


339 


ill 

•*     0     TH     CO     0    0      T3 

^^  en   iH  o   oo   !>•  co   LO   co   ^o   o   o  o> 

^  ** 

CO     O     rH     TH     rH     Cn        0) 

i—  1                                           "3 

i 

M* 

h 

a<o&n 

00         •     T-t     LO     LO    CO        I* 

•f<      •   t-   LO   oo   co     5; 

t-     LO     77          •     7)     77      77     -T     77      ~~     1  C     LO     LO 

s 

c 

G 

*il 

OO        "    OO    0}    LO    !>•       j 

~    .-.I       *    j, 

O 

L 

1 

77      77     CO         -OO»Hr-tT-li-HLOi7i-: 

•   T-iiHcncncnencnencn 

o 

I 

CO    t-    OS    O    O    00 
LO     LO     00    O     O     Oi      Jd 

rH                       T-l     rH                IS 

•fl 

cnt-'                cocoTHCOcnenco 

43 

f 

1 

LO 

|| 

.H    t-    0    0    0    0       g 

10   LO   IH   TH   T-I   en     ,2 

ScocoLo'^ooScoMtSLo^Lo' 

»$ 

r: 

'3 

X 

S" 

"g 

^ 

-r      •   ^j   LO   to   en     -2 

g 

77      '—      TO         -I—  'C'OTTM'COLOOi—1-!—  ' 

e 

!>.        •     CO     LO     00     CO        & 

i 

iH     i-i         •                       t—Cn              T-iiHrHCO 

•     t-    OS     LO     CO       42 


co   en    TO   t~   LO   co   t~ 


UJ 


3    8 

§§go'§§§         £     £       ^§§§§§§§§§§§0 
"'cnr-iavico  ^       en.coLo'~'"<r-!t~cooooot-ooco 


.    co    So"      •  .    a 

a  ja  ,2    «-         t-    3 

rH     ^     iH      CS     LO      &    r-1 


—     —     — 

X     ~     ~ 

o    o    c? 


.£  ,a    o   4£ 

QS  O     c     O 

2  I  !  i  :  i  i  M  *  s     * 

j  j    j   i       i   illH" 


••-"    .      o)    -i   *~^ 

JM       t<       £•       CO       O       Cj 

•o  -o    u  S   §   g 


5  3       3  «  5 

«    €>    3    O  |j    8    J 

~  ^  x  /?:  o  D-  E- 


340 


THE    HOME   DIETITIAN 


**      a) 

*H 
&  * 

"O" 

£j;2 


m 


il 

51 


eOt-t*-t-COiHt-0000 


Suroo^oo 

OOCOOT-lb-Ci 


OO    OO    t-    <M     ©    -rt<    CO    CO        •        •    O    LO     -"f    "*f    O    CO    iH    &}    O     O        •        •     '0 
(M(MC<JCO'*THi-lTH        •        -iniT-liH<MTH  rH  r-ii-i        •        ->O 


oeotoeotoeoc4.ua 

t-U?aii-lt-.OT-! 
iH    ^  rH    r-l    <M 


CO    00   CO   64  <M 


«5^LO(MC<lTH«>lO        •        •CSr-lt-t-lMCnOt-CO'M        '        -OCOIM 
lOOt-tHrHcOiMC'O''  iH  rH  COrH  IT5        •        •    <M    «O 


8888888888888888888 


a  a 


ft  ft 

3    3 

ft    ft    ft 

333 

a 

3 

a 

ft  ft 

3    3 

3    3 

a& 

3    42 

ft 

3 

&l 

a  ^2 

a  a  a  a 

2    CJ>    9 

I  2  2  1 


ft     ft    02 

oT   aT   o? 
333 

PQ  CQ  PQ 


02 


DO 

3  3 

oJ  03 

O>  •- 

PQ  PQ 


'rots,  mashe 
ery,  chopped 


FQ  ffl  PQ  PQ  Q 


c8 


0) 

0 


10  'o  "o 

«    O    3    3 
I   1   1   1    I 

.  a  a  a  £ 

33333 


55655 


0) 

_    ^ 

1« 


o    o 

O  O 


er  crumbs 
berries,  raw 


el 

o  o 


APPENDIX 


341 


tal 

So. 


T7         •     O     <M     O     rH         -l-OCOOOOOOOO 


co  eo  to  to 


lOUSOOOOt- 


eo  co  ia  10 


r-l  CO     M 


10         in  co 


00    O        '     •«*     (M     <M     CO         •©«O©t*-©iH«O©t*-i-IC»OSOOOO©iH?e> 


-»f        -OOlO(M<Mr-IOO 
CO-tOiOpH  CO  r-l 


N      N      N      N      S3      N      S3      S     XJ      X      N      N      N      N      N      N      N      N      N      N      N      N      N      N      N 

oooooooo-<oooooooooooooooo 


0) 
ft     ft    ft    £? 


a  ft  i  .„„_..„    ._    , 

gssssdSrt^-0 
oooooo-S^-^ 


3,5    b^    3^    53^ 
o-^o-^o-^ooc 


94  p, 

»  ft 

3  o 


0  -S  £  a 

V    oT  af  •r' 

£  3  *s  p 

a  g  §  „ 


^  bf  f  1 1  : 

1  ?  1 1 1 1 1 

^  ft  &  Xi  O  55    C 


a  2  ®  i 

s  *  •«  x 
•§  ^  ^  a 


.2  g  u  c 


O  Q  U 


M    to    fa    h    h    h 

p     s     5     ,3    3    j-5 

O     O    ^     O     O     O     O 


EE 


b  b  b  b  a 

sill® 
gg  g  g  g 


342 


THE    HOME    DIETITIAN 


Ijl 

111 


<M  "*  tO  CO  OS 


to    10  10 


o  o  to  HH  to  to   •  os  t~  os  o; 


to 

os   co   co   »o   cxi   CAI   co   oo 

tr     00     00     00     00     00     ^C     00 


OS     "*     Tt*     TH     O     O     O 


OS<X>lOlOOO<NIOOOSC<IOOt—     OtOOO^tOOSOCOCOOtOOCO 
O    O     r-i  OTH^THOStOlOCC'OOiMC^lO^OOCOt-THt-OOOOS 

1OOO  <M     C-  <M     CO  i— I  CO  «S  O     OS     CO     r-i     O     t-    TH 


tOOUSlO<NCOC<IOM<OOt~'*t<OOlOOO-*tOOtOCOt~OSTHTHOO 
C<l     TH     r-t  OS     OO     CO     tO     C<1     CO     IO     'st*     -"t1  OO     IT     jf     T—     rr     CO     lO     OS     OS     M     OS 


to 
o   01 


00  IO  t~  OS  tO  ^  MH 
C~  O  TH  IO  00  "*i  CO 

00     00     r-i     OS     00     -^    O 


O     C<J     OS     OS 

JH    TH    e,    to 


o      •      •   t-   t-   10   os   oo   os 

<£         •         •     TH     "t1     CO     CO    TH     O 


R       N      N 

•§    o    o 


NNX^XXXXX 

OOOoOOOOO 


iOOOrH  OOt-0000-t 


00     00  00 


a  a  co   03   a 

5     S3    ^    X3     3 


a  5T  a 

3    42    3 


a  a  a  a  a  a  a 

3     =     33333 


OJ    TJ 

a  o>  -c 

&s  s 


. 


2   2  33  S 


J2  S   S   2 


»    •  2  g 

o    g    |  | 

^111 


d 
d 


l, 

s, 


illil 

3  "3  "3  w  S 


^     3     pj 

«  s  c  a  s  g  I 

ri    c6  W   cc   «    a   a 


c*  a  §  §§^|  s  I  i  S  a  ^  af  a?  3 1  **  3  5  3 1 

L     O     n  3    <n    w    flv    C9    0?    »^-«    "— <    •'^    *^^     O    O    £9    9    9    9    0 

cj»N533jjssssgssssisgss5^S55?a 


"3  "3  "3 
fc  55  ^ 


APPENDIX 


343 


ill!— 


«C    OO    O    O    00    l»    O 
00    <N    TH    O    <M  10 


§  2  §  g  g  g  S  8  8  8  §  §  8  g  §  8  g  8  g  8  S  S  8  § 


a  a 

3     3 

«    « 


ll 

o  ? 


5  3  5  •  :  :  *  : 

•o  TJ  -a  g»  :    :  I  : 
S  •  j  3  2    • 


"2 


oooooooooofXfSaicucutiJ&'Cu 


344 


THE    HOME    DIETITIAN 


s,$. 


00  "*      r-i  T-l 


r-i  r-l  CO  CO      r-l 


C<l    TJH  tr-    S<1 


OOOr-ilOr- IrHr-iLOCMi— lOCSCD** 
CM     iH  <M     GO     <M     CO  r-l  r-l  <X5 


r-l     CO  r-l 


r-l  00 


U5      LO 

U5    -COO    -THCOOCM 
CO    •  iH  TH    •  CO 


o  io  o  TH  «e  •**«  o .  to 


a  a  a  a 


0000 


5  g« 


ta 


,11 
S  i  ^ 

O     «     M 

«.fl    «T 


1-4       CJ      r^< 

•w     «     S 


«"     M    -£2 


t.    T3 

•g"  '§  s  s  I 
2:3 1  s  § 

a    n  S    m    g 

<W     ^  s.     ^ 

•p  -p  c  p  _^ 

^     ^  V,     H    -0 


If  Iff  p!!H 

o   S   ^   s   ce   c§ 

PH    CU    OH    OU    tf    tf 


a;  a  a  a  -^   oT  9  9 

o3    ei    ed    cdj3.FH.rt    p^ 


;!• 


APPENDIX 


345 


.3 


si- 

&4<3 


§OOOOOOO<MlO<MOOCO-<t< 
OOOOOOOt-U5C-^<COOOO 


TH    t-    O    to     "f     **>     »t 


TH     O     Ii5     CO     C<I     <M     <M     l3     (M 

Mi— INiHr- IT— ItHrH 


M    -        CO 


73    T3 

2  S 

V     0) 

Tj     TCJ 

!! 


s    s 

C/3    CO 


•a 

.     —     —Q) 

' 


•  T3  -O 

73    73       •  0)  0> 

OJ     0)    _^  ^  ^ 

•^    ^    ^  O  O 

n     n     &  n  o 


INDEX 


Absorption,  of  food,  14,  15. 

of  poison,  23,  24. 
Acidosis,  52,  63,  86,  89,  90.  248. 
Acid  phosphate,  85,  112,  113. 

salts,  93. 
Acids,  acetic,  142. 

amino,  19,  23,  43,  76,  127,  128. 

carbonic,  18,  85,  86,  112,  113. 

combined  with  starch,  173,  192. 

fatty,  52,  53. 

fruit,  93,  173,  174,  221. 

hydrochloric,  23,  84,  113,  114. 

in  baking  powder,  112. 

in  the  digestive  tract,  31,  85. 

iso-lactic,  85. 

lactic,  118,  194,  267. 

metabolic,  31,  52,  85,  102,  249. 

phosphoric,  85,  86. 

sulphuric,  82,  85,  86. 

uric,  19,  28. 
Acne,  52,  241. 
Alcohol,  23,  145,  146. 
Alcoholism,  24. 

Alkali,  71,  84,  85,  86,  87,  88,  113. 
Alkaline  salts,  84,  85,  86,  87,  88,  91. 
Alligator  pear,  11,  50. 
Almonds,  47,  338,  342. 
Alum  baking  powder,  112,  113. 
Amino  acids,  19,  23,  43,  127,  128. 
Amylopsin,  59. 
Analysis,  13. 
Anaphylaxis,  278. 
Anemia,  25,  40. 
Angina  pectoris,  28. 
Animals,  diseases  of,  132-134. 
Antitoxic  diet,  193,  243. 
Apoplexy,  28. 
Appendicitis,  220. 
Appetite,  22,  159,  186,  187,  272. 
Apple  and  celery  salad,  316. 

baked,  335. 

dried,  339. 

fresh,  334. 

juice,  335. 

pie,  337. 

sauce,  335. 
Apricot,  fresh,  334. 

sauce,  335. 

Apricots,  dried,  335,  339. 
Arteries,  hardening  of,  28.  244. 
Arteriosclerosis,  28,  137,  244,  246. 
Arthritis,  242. 

Artificial  sweets,  62.  65,  66,  153,  181,  182. 
Asparagus,  100,  105,  107,  166,  251,  332. 
Asthma,  241,  275. 
Auto-intoxication,  21,  234. 

Babies,  66,  178,  179,  180,  181. 
Bacon,  331. 
Baked  apple,  335. 
Baked  banana,  328. 
Baked  carrots,  312. 
Baking  powder,  112,  113,  114. 
Balanced  ration,  38,  49,  281. 
Banana  croquettes,  328. 

snow,  324. 

Bananas,  96,  324,  328,  334. 
Barley,  crushed,  339. 

flour,  341. 

346 


Barley,  pearled,  329,  339. 

Bases,  87. 

Beef,  331. 

Bean  sandwich,  171. 

tomato  soup,  299. 
Beans,  46,  100,  332,  333. 

croquettes,  302. 

protein  of,  41,  45,  46,  79,  100,  101. 

string,  48,  250,  333,  340. 
Beet  greens,  48,  250,  333. 
Beets,  48,  333. 
Beriberi,  69,  70. 

vitamine,  73. 
Bilious  attacks,  24,  231. 
Biscuits,  329. 
Blackberry  juice,  335. 

sauce,  335. 
Blackberries,  334. 
Blood,  circulation  of,  30. 

poisons  in,  16,  23. 
Body  as  a  stove,  17. 
Boils,  52,  241. 
Boston  roast,  306. 
Bouillon,  vegetable,  155,  294. 
Bowel,  catarrh  of,  142,  143,  241. 

putrefaction  in,  23. 
Boys,  food  for,  187. 
Brain  workers,  food  for,  42,  161. 
Bran,  109,  340. 
Brazil  nuts,  338. 
Bread,  as  a  protein  food,  41,  47. 

caloric  value  of,  329,  340. 

coarse,  202. 

corn,  286. 

demineralized,  63,  64,  88,  90,  110,  111, 
185. 

devitalized,  88,  90,  109,  112. 

fresh,  111. 

home-ground  wheat,  110. 

oatmeal,  288. 

rye  and  Injun,  288. 

stale,  111. 
Bread  crumbs,  340. 
Breakfast,  157. 

no  breakfast,  191. 

sample  menus,  163,  164,  165,  211,  212, 

213,  251-257. 

Bright's  disease,  28,  137,  143,  244. 
Broiling,  54. 
Bromine,  11. 

Broths,  vegetable,  80,  107.  155.  156,  162, 
179,  222,  235,  242,  249,  251,  258,  261, 
294,  295. 

meat,  135,  150. 
Brown  rice,  80. 
Brown  sauce,  313. 
Browned  potatoes,  310. 

rice,  237,  294. 
Buns,  329. 

Building  stones,  19,  43,  128. 
Butter,  50,  53,  54,  73,  120,  121,  164,  184, 
202,  228,  237,  238,  241,  330,  340. 

vegetable  213. 

Buttermilk.  46,  116,  159,  173,  194,  225, 
226.  230,  236,  238,  242,  245,  262, 
267,  272. 

Cabbage,  48,  100,  101,  104,  258. 

caloric  value  of,  48,  104,  245,  333,  340. 


INDEX 


347 


Cabbage,  cooked.  245,  333. 

raw.  104,  245,  333.  340. 

salad,  317. 

Caffeine,  28,  135,  147,  148. 
Cake,  154. 

caloric  value  of,  336,  337. 

for  children,  183. 

without  sugar,  326. 
Calcium,  11,  63,  66,  90,  93,  105,  222. 

carbonate,  81. 
Callous,  142. 
Caloric  value  of  food,   33,  35,   187,  262, 

281,  329. 
Calorie,  32. 
Calorimeter,  32. 
Candy,  90,  153,  182.  188. 
Cane  sugar,  60,  62,  65,  66,  89,  96,  174, 
181,  188,  241,  282. 

caloric  value  of,  338,  344,  345. 

combined  with  milk,  153,  174. 
Canned  foods,  78. 
Canteloupe,  334. 
Caramel  puddings,  327. 
Carbohydrates,  11,  28,  29,  42.  43,  58-68. 

75,  188,  233.  247. 
Carbon,  11,  13,  18,  49. 
Carbon  dioxide.  18.  85.  86.  112,  113. 
Carrot  and  cottage  cheese  salad,  316. 

and  nut  loaf,  307. 

cottage  cheese  sandwich,  170. 
Carrots,  258,  282,  333,  340. 

baked,  312. 

tops,  105,  107. 
Casein,  12. 

Catarrh.  52.  184.  237,  241. 
Cauliflower,  48,  101,  333. 
Celery,  48,  101,  333,  340. 

and  nut  roast,  308. 

sandwich,  171. 

soup,  299. 

tops.  101,  105,  107,  258,  295.  296. 
Cellulose.  11,   12.  13,  58,  92.  99.  101. 
Cereal  coffee.  163.  164,  169.  314. 

pudding,  321. 

Cereals,    11,   44.   65.   109,   114,    115,   220, 
225.  226. 

caloric    value   of,    47,    329,    341,    342. 
343,  345. 

how  to  cook,  115. 

monotonous  diet  of,  44,  115,  207. 

proteins  of.  44,  47,  114. 

vitamines  of,  77. 
Cheese.  116.  120.  331. 
Chemical  elements,  11. 

action,  in  digestion.  14,  59. 
in  the  plant,  13. 
in  the  tissues,  18,  60,  85. 
Cherries,  334. 
Chestnuts,  338. 
Chicken.  134.  227.  331. 
Children,  feeding  of,  178-188. 
Chittenden  standard  of  protein,  233. 
Chlorine.  11. 
Chlorophyll,  13.  102. 
Chocolate.  149.  337. 

cake,  336. 

cream,  337. 

Chronic  disease,  232.  259. 
Chyle,  16. 
Chyme.  22. 
Circulation  of  blood,  16,  30. 


Citrous  fruits,  94. 

Clams.  279.  331. 

Cocoa,  149,  186,  337,  340. 

butter,  149. 
Cocoanut,  shredded,  338,  340. 

drop  cakes,  327. 
Coffee,  147.  148,  186,  338. 
Colds.  220. 
Combinations.   153.  172.  191.  196,  282. 

fruit  and  milk,  174. 

fruit  and  vegetables.  153,  173. 

milk  and  augar,  123.  153,  174. 

starch  and  acid,  173.  192. 

two  kinds  of  fruit,  176.  192. 

two  starches,  176,  192. 
Complete   proteins,    43,    44,    45,    76,    99, 

128.  129.  222. 
Concentrated  foods,  42,  62-65,   184,  211. 

239. 

Condiments,   140-144,  241. 
Conservation  of  food,  198-204. 
Constipation,  23,  25,  147,  179,  239,  240, 

241,  268. 

Convalescent,  38,  43,  227. 
Cooking,  of  cereals,  115. 

of  sugar,  96. 

of  vegetables,  78.  105,  106,  107. 
Co-operation  of  child,  186. 
Corn,  45,  70,  71. 

bread,  286.  329. 

canned,  333,  340. 

chowder,  301. 

dodgers,  287. 

flakes,  226,  293,  329. 

green,  333. 

meal,  329.  340. 

soup,  298. 

starch,  340. 

Cornstarch  pudding,  323. 
Cottage   cheese,   46,    120,    157,    160,    170, 
184,  194,  227,  242,  262,  267. 

in  salad,  316. 

and  nut  roast,  306. 

omelet,  306. 

tomato  sandwich,  170. 
Cracked  wheat,  47,  114.  330,  345. 

gruel,  330. 

Cracker  crumbs,  340. 
Crackers,  154,  329. 
Cranberry  sauce,  335. 
Cranberries,  raw,  340. 
Cream,  41,  50.  54,  77,  121.  184.  202,  225, 
228,  236.  237.  241,  263. 

average.  331.  341. 

dressing.  320. 

egg  toast.  291. 

heavy.  331.  341. 

of  tartar,  112.  113. 

of  wheat,  330.  345. 

puree  of  peas  on  toast,  291. 

rolls,  286. 

soup,  296,  297,  298. 

tomato  toast,  290. 
Creatin,  19,  28. 
Crisco,  341. 
Croquettes,  banana,  328. 

bean.  302. 

eggplant,  307. 

split  pea,  309. 
Cucumber  jelly,  319. 

pulp,  341. 


348 


THE    HOME   DIETITIAN 


Cucumbers,  48,  333. 
Currant  jelly,  335. 
Currants,  334,  341. 
Custard,  337. 
Cycle  of  life,  11-16. 

Dairy  dishes,  330. 

products,  116-129. 
Dates,  163,  241,  335,  341. 

stuffed,  337. 
Defective  food  analysis,  21,  27,  281. 

food  ration,  11. 

Deficiency  diseases,  40,  71,  88,  235,  259. 
Demineralized  bread,  64,  65,   109,  185. 

foods,  64,  88,  90. 
Desserts,  123,  151,  160,  336. 

for  children,  182,  183. 

recipes  for,  321. 
Devitalized  food,  70,  71,   72,  78,   88,  90, 

105. 

Dextrin,  58,  59. 

Dextrinized  foods,   14,   59,   79,    111,   226. 
Dextrose,  14,  59,  60,  92. 
Diabetes,  60,  247-258. 
Diet,  corrective,  184. 

flesh,  124-139. 

for  children,  178-188. 

for  convalescents,  43,  223,  229. 

for  invalids,  218,  232,  259,  265. 

if  too  thin,  43,  234-238. 

in  obesity,  30,  34,  39,  244-246. 

milk,  191,  195,  265. 

monotonous  cereal,   44,   115,  207,   281. 

raw  food,  104,  191,  196. 

vegetarian,  40,  75,  79  (footnote),   124. 

126,  128,  130,  138,  139. 
Digestion,  14,  15,  16,  21,  23,  24,  25,  51, 

59,  60,  64,  234,  235. 
Digestive  ferments,  69. 

juices,  14,  21,  22,  59. 
Dinner,  159,  160. 
Diseases,  acute,  218. 

chronic,  232,  259. 
Disease  of  animals,  132-134. 
Diseases  spread  by  milk,  119. 
Doughnuts,  337. 
Drinking  at  meals,  177,  283. 
Dyspepsia,  25,  234. 

Eating  between  meals,  186,  283. 

purpose  of,  140,  189,  198,  199. 

regularity  of,  178,  186,  283. 

too  fast,  21,  22,  283. 

too  little,  29,  40,  80,  188,  193,  194,  223, 
235,  259,  276. 

too  much,  29,  37,  40,  199,  200,  244. 

too  often,  158,  159,  283. 
Economy,  129,  198-204. 
Eczema,  52,  71,  179,  241. 
Egg  gravy,  312. 

sandwiches,  170. 

yolks,  11,  123. 
Eggs,    11,    12,   42,    45,   46,    50,    117.    121, 

122,  123,  157,  159,  185,  20*. 
Eggnog,  123,  328. 
Eggplant,  48,  333,  341. 

croquettes,  307. 

scalloped,  312. 
Elimination,  19,  28,  29. 

of  carbohydrate,  18,  20. 

of  fat,  18.  20,  51. 


Elimination  of  protein,  20,  38. 
Emaciation,  225. 
Endocrines,  243. 
Endurance  of  vegetarians,  138. 
Excretion  of  fatty  acids,  52. 
Exercise,  30,  40,  187. 
Exophthalmic  goiter,  242. 
Experience,  276. 
Extracts,  meat,  135,  145,  150. 
vegetable,  106,  107,  155,  157. 

Fads,  189-197. 

Farina,  see  Cream  of  wheat. 

Farina  mold,  322. 

Farmer,  food  for,  34,  42,  160. 

Fasting,  190,  193. 

Fat-soluble  vitamine,  50,  53,  73,  77,  100, 

103,  120,  121,  265. 
Fats,  11,  49-57,  120,  184,  228. 

average  consumption  of,  50. 

classification  of,  49,  50. 

combined,  50. 

conservation  of,  202. 

decomposition  of,  52,  53. 

digestion  of,  15,  51. 

effect  on  digestion  of  protein,  51. 

elimination  of,  18,  20,  51. 

emulsification  of,  15,  51. 

free,  35,  50. 

metabolism  of,  18,  51. 

oxidation  of,  18,  51. 

required,  35,  50,  56. 

superheated,  52,  54,  161. 

where  found,  11,  50. 
Fatigue,  effect  of  vegetarian  diet  upon, 

138. 
Fatty  acids,  52,  53. 

heart,  30,  244. 

seasoning,  54,  62. 

Feeding  of  children,  77,  80,  178-188. 
Fermentation,  23,  63,  89. 
Ferments,  69,  278. 
Fever,  260. 
Figs,  334,  335. 
Filberts,  338. 
Fish,  331. 

Flesh  food,  124,  139,  331. 
Food  balance   distributed,    41,    Ml,    K,2. 

158. 
Food,  classification  of,  11. 

dead,  78. 

decomposition  of,  23,  24,  193. 

idiosyncrasies,  273. 

predigested,  14. 

protein,  18,  38-48,  75,  82,  85,  99,  116- 
123,  127,  155,  159,  160,  236,  245. 

quartet,  220. 

raw,   104,   191,  196. 

required,  34,  161. 
by  child,  187. 

unit,  32. 

values,  32-37,  187,  281. 

vital,  76. 

Flour,  109,  110,  111,  341. 
Flourine,  11. 

Forced  feeding,  190,  194,  260. 
French  dressing,  320. 
Fruit,  77,  92-98,  122,  153,  158,   159,  173, 
174,    175,    176,    182,    211,    235,    240. 
334,  335. 

acid,  84.  87,  92,  93. 


INDEX 


349 


Fruit,  fresh,  96,  158,  240. 

juice,  93,  179,  220,  221,  242,  261. 

mold,  325. 

salad,  315,  316. 

stewed,  96,  158. 

sugar,  59,  60,  92. 

toast,  290. 
Frying,  52. 

without  grease,  •">  I . 
Funk,  Casimir,  72. 

Galactose,  60. 

Gastric  ulcer,  238. 

Gems,  110,  114,  285. 

Germ  activity,  23. 

Girls,  food  requirement  for,   187. 

Glucose,  see  Dextrose. 

Gluten,  293. 

Glycogen,  59. 

Goiter,  exophthalmic,  242. 

Goldberger,  70. 

Golden  dressing,  321. 

Goose,  332. 

Gooseberries,  334. 

Graham  bread,  109. 

puffs,  285. 
Grains,  see  Cereals. 
Granola,  329. 
Granose  biscuits,  330. 
Granuto,  329. 
Grapefruit,  212,  334. 

salad,  316. 
Grape-nuts,  329. 
Grape  salad,  315. 
Grapes,  334. 
Gravies,  155,  161. 
Greasy  foods,  55. 
Green  pea  sandwich,  171. 
Griddle  cakes,  185,  330. 
Grits,  hominy,  330. 

wheat,  330. 
Gruels,  158,  226,  293,  330. 

Haddock,  332. 

Halibut,  332. 

Ham,  332. 

Hardening  of  the  arteries,  244. 

Headache,  24,  25,  148,  231. 

Hemoglobin,  102. 

Heart  disease,  28,  244,  246. 

High  blood  pressure,   28,   137,   244,   246. 

Hives,  279. 

Home-ground  wheat,  110. 

bread,  289. 

Homemade  protose,  305. 
Hominy,  330.  342. 
Hominy  grits,  330. 
Honey,  60,  62,  89,  183,  212,  1537. 
Hormones,  69. 
Horse  meat,  133. 
Huckleberries,  334. 
Hunger.  22,  151. 

Hydrochloric  acid,  23,  84,  113,  114. 
Hydrogen,  11. 
Hygienic  hot  cakes,  292. 
Ice  cream,  154,  183,  337. 
Idiosyncrasies,  273. 
Indigestible  foods,  22.  51,  52,  54,  96,  111, 

120,  152,  173,  185,  282. 
Indigestion,  21,  22.  23.  231,  235. 
Influenza,  230. 


Intemperance,  143. 
Internal  secretions,  60,  69,  242,  243. 
Intestines,  digestion  in,  14,  15,  51,  59. 
fermentation  and  putrefaction  in,  15, 

23,  25,  51,  136,  193,  266. 
Iodine,  11,  83. 
Iron,  11,  102,  121. 
Italian  salad,  317. 

Jelly,  cucumber,  319. 

currant,  335. 

orange,  325. 

roll,  336. 

tomato,  318. 

Jewish  method  of  slaughtering,  135. 
Junket,  182,  233,  267,  337. 

Katabolism,  17,  31. 

Kidneys,  18,  19,  27,  137,  142,  143. 

Krumbles,  330. 

Lady  fingers,  337. 

Levulose,  14,  60. 

Lamb,  227,  332. 

Lard,  50. 

Leaf  vegetables,  76,  77,  79,  100,  101,  103, 

180,  210,  211,  238,  245,  249. 
Leaves,  76,  77,  99,  100,  101,  107,  208. 
Legumes,  11,  100. 

protein  of,  46,  47,  79. 
Lemon,  142,  334. 

juice,  142,  336,  342. 

pie,  337. 

sauce,  322. 
Lemonade,  336. 
Iventil  sandwich,  171. 
Lentils,  47,  100,  333,  342. 
Lettuce,  48,  99,  333,  342. 

sandwich,  171. 
Liquid  diet,  229. 
Lobster,  332. 

Low  protein,  40,  191,  194,  223,  234. 
Lumbago,  28. 
Lunch,  159. 

for  school,  186. 
Lungs,  16,  30,  51. 

Macaroni,  47,  338,  342. 

Macaroons.  337. 

Magnesium,  11,  82. 

Malnutrition,   40,   235,   237.   259,   269. 

Malted  milk,  338,  342. 

nuts,  212,  339. 
Maple  sirup,  338,  345. 

sugar,  338. 
Mastication,  21,  102,  175.  185,  196,  282, 

283. 

Mayonnaise  dressing,  319. 
McCann,  90,  261. 

McCollum,  73,  77,  79,  100,  101,  126,  127. 
Measles.  230. 
Meat.  12,  40,  124-139,  201,  282. 

extracts,  135,  145,  150. 

substitutes,  46,  155-171. 
Mechanical  phase  of  digestion.   13. 
Melons,  335. 
Meltose,  339.  342. 
Menus,  breakfast.  163.  211. 

dinner,  165,  214. 

for  diabetic  patient,  251. 


350 


THE    HOME   DIETITIAN 


Metabolism  of  carbohydrates,  18,  29,  60. 

of  fats.  18,  61. 

of  protein,  18,  20,  28. 
Milk,  12,  41,  47,  50,  76,  77,  116,  129,  152, 
158,    184,    191,    195,    206,    224,    261, 
269,  331,  342. 

a  protective  food,  101,  129. 

boiled,    119,    175,    224,    230,    236,    238, 
267. 

caloric  value  of,  47,  331,  342. 

diet,  191,  195,  263,  265. 

evaporated,  226,  331,  342. 

for  children,  180. 

mixture  for  babies,  179. 

mother's,  179. 

Pasteurized,  70,  119,  179. 

protein  of,  47,  122. 

skim,  47,  268. 

vitamines  in,  53,  76,  116,  121,  265. 

with  fruit,  174. 

with  sugar,  153,  180. 
Mill  for  grinding  wheat,  110. 
Mineral  salts,   12,  81-91. 
Molasses,  90,  337,  342. 
Muscle  tissue  as  food,  127,  128. 
Mush,  227. 
Mushrooms,  333. 
Mustard,  141. 
Mutton,  332. 
Myalgia,  28. 

Nervous  diseases,  25. 
Neurasthenia,  25,  235. 
Neuritis,  28. 
Nitrogen,  12,  18,  28,  38. 
Nitrogenous    combinations,    19,    43,    76, 
127. 

equilibrium,  38. 

foods,  see  Protein. 
No  breakfast,  191,  195. 
Nut  butter,  170,  339. 

cream  toast,  291. 

fillet,  304. 

gravy,  313. 

protein,  208. 

tomato  macaroni,  308. 

tomato  rice,  212,  308. 

tomato  sandwich,  170. 

tomato  toast,  211,  292. 
Nuts,  11,  47,  97,  153,  208,  209,  338,  342, 

343. 
Nuttolene,  47,  304,  343. 

Oatmeal,  41,  157,  330.  343. 

as  a  protein  food,  41,  47. 

bread,  288. 

gruel,  293,  330. 

Obesity,  29,  30,  39,  233,  244,  245,  246. 
Olein,  49. 
Oil,  11,  50,  54,  162. 

cooking,  343. 

olive,  54,  237,  343. 

salad,  343. 

Olives,  97,  237,  251,  262,  339,  343. 
Onion,  100,  101,  333,  343. 
Orange,  94,  245,  334. 

jelly,  325. 

juice,  94,   95,   165,   166,   179,   229,  240, 
271,  336. 

marmalade,  336. 
Osteomalacia.  72. 


Oven  toast,  14,  111,  185,  238,  290. 
Overeating,  29,  37,  50,  151,  199,  200,  239, 

263. 

Overflavoring,  140. 

Oxidation,   17,  18,  27,  28,  32,  51,  52,  60. 
Oysters,  332. 
Oxygen,  11,  13,  17,  20,  30. 

Palmatin,  49. 

Pancreatic  juice,  59. 

Parsnips,  333. 

Pasteurized  milk,  70,  119,  179. 

Peach,  fresh,  334. 

juice,  336. 

sauce,  336,  343. 
Peaches,  dried,  343. 
Pear,  fresh,  335. 

juice,  336. 

sauce,  336. 

Peanut  butter,  170,  339,  342. 
Peanuts,  45,  47,  338,  342. 
Pea  pods,  105,  107. 
Peas,  dried,  33,  343. 

green,  333,  343. 

puree,  343. 

puree  on  toast,  291. 
Pea  tomato  sauce,  314. 
Pecans,  338. 
Pellagra,  70,  71. 
Pepper,  141,  143. 
Peptones,  14. 
Phosphorus,  11,  82.  83. 
Physical  changes  in  digestion,  14. 
Physical  superiority  of  vegetarians,  138. 
Pie,  152,  183,  337. 
Pimples,  52,  241. 
Pineapple,  315,  335,  343. 
Pine  nuts,  338. 
Plum,  fresh,  335. 

juice,  336. 

sauce,  336. 
Poisons,  24. 
Pork,  133,  331. 
Portal  vein,  16. 

Potassium,  11,  81,  83,  86,  87,  222. 
Potato,  100,  101,  105,  160. 

baked,  108,  158,  333. 

boiled,  333. 

fried,  185. 

mashed,   334,  344. 

puffs,  310. 

skins,  100,  101,  105,  106. 

soup,  296. 

soup  stock,  296. 

stuffed,  310. 

sweet,  334,  344. 

water,  344. 
Predigested  food,  14. 
Protective  foods,  101,  129,  207. 
Protein,   12,   18,  28,  34,  38-48,   127,    128, 
137,  160,  207,  236. 

animal,  122,  127,  206. 

balance  disturbed,  41. 

complete,  19,  43,  223,  281. 

excess,  137. 

foreign,  277. 

in  tuberculosis,  260,  262. 

legumes,  79. 

low,  40,  191,   194,  223,  234. 

meat.  127. 

metabolism  of,  18,  20,  2s. 


INDEX 


351 


Protein,  milk,  47,  116,  122. 

nut,  98,  208. 

related  to  vitamines,  75. 

vegetable,  99,  173,  207,  210. 
Protose,  303. 

and  nuttolene  sandwich,  171. 

and  potato  hash,  305. 

braised.  304. 

homemade,  305. 

loaf.  303. 

patties,  303. 

sandwich,  171. 

with  onion,  303. 
Proteoses,  14. 
Prunes.  241,  335,  344. 

stuffed,  323. 
Prune  fluff  toast,  290. 

marmalade,  336. 

whip.  323. 

Ptomaine  poisoning,  24,  136. 
Pumpkin,  344. 

pie,  337. 
Putrefaction,    15,    23,    25,    51,    135, 

193,  242,  266. 
Pus  infections,  241. 

vegetable  salad,  79,  104,  160,  318. 
Pyorrhea,  71,  264. 

Quality  of  fat,  53. 

of  food,  281. 

of  protein,  19,  43.  44,  126. 
Quantity  of  food,  22,  34. 

Raisins.  182.  335.  344. 
Rancid  fats.  52.  54. 
Raspberry,  black,  juice,  336. 

sauce.  336,  344. 

Raspberries,  black,  fresh,  335,  344. 
Raspberry,  red,  juice,  336. 

sauce,  336,  344. 

Raspberries,  red,  fresh,  335,  344. 
Ration,  balanced.  38-58. 
Raw  food  diet,  104,  191.  196. 

vegetables,  77.  79.  101,  104,  238. 
Recipes,  284-328. 
Regularity  in  eating  178,  283. 
Rheumatism,  28,  137,  244. 
Ribbon  loaf,  302. 
Rice,  62.  344. 

biscuits,  330. 

brown,  79. 

browned,  79,  165. 

flakes,  330. 

polished,  62,  70,  72,  78,  80,  330. 

puffed,  330. 

whole,  330. 

Rickets.  66,  71,  74.  179. 
Rochelle  salts,  113. 
Rolled  oats,  343. 
Rye  and  Injun  bread,  288. 

Salad  dressing.  319. 

sandwich,  171. 
Salads,  79.  104.  160,  315. 
Salmon,  332. 
Salt,  table.  247. 
Salts.  12,  81-91. 
Sandwiches.  170.  171. 
Saponiflcation,  15. 
Savora.  302. 


Sauce,   fruit,   335,   343,  344. 

vegetable,  162,  313. 
Sausage,  133,  332. 

casings,  133. 
Scarlet  fever,  230. 
Scurvy,  70,  73,  74,   103,   179. 

vitamine,  73. 

Sedentary  habits,  34,  39,  42,   161. 
Seeds,  dietary  properties  of,  79,  100. 
Self-control,  181. 
Self-poisoning,  21,  234. 
Sensitization,  278,  279. 

tests,  279. 
Shad,  332. 

Shellfish,  279,  331,  332. 
Sherbet,  338. 

Shredded-wheat  biscuit,  158,  330. 
Silicon.  11. 

Skin,  diseases  of.  52,  241. 
Skins  of  fruits,  77. 

of   vegetables,    77,    78,    100,    105,    106, 

258,  295. 

136.        Slaughter-house  inspection.  133. 
Soda,  81,  84,  112,  113,  114,  297. 
Sodium,  81,  82,  83,  85,  87,  88. 
Soups,  107,  159,  184,  294-302. 
Soy  bean,  11,  45,  46,  333,  340. 
Spices,  241. 

Spinach,   36,  48,   99,   100,   101,    152,   311, 
334,  344. 

souffle,  311. 
Spaghetti,  344. 
Squash,  334,  344. 
Starch,  11.  13,  14,  58,  62,  64. 

and  acids,  173,  192. 

changed  into  sugar,  13,  58,  59. 

digestion  of,  174. 

in  excess,  63,  64. 

making,  13. 

Starchy  foods,  62,  63,  64,  65. 
Stearin,  49. 

Stimulants,  unnatural,  145. 
Stomach,  digestion  in,  14,  21,  22,  51. 

effect  of  condiments  on,  141,  142. 

effect  of  free  fat  on,  51. 

effect  of  coffee  on,  148. 

stagnation  in,  23. 

time  for  rest,  158,  159,  195,   196.  l>s:5. 
Strawberry  juice,  336. 

sauce.  336,  344. 
Strawberries,  fresh,  335,  344. 
String  bean  salad.  317. 
String  beans,  48,  333,  340. 
Suboxidation,  27-31,  244. 
Sucrose,  60. 

Sugar,    11,    13.    16,   41.    59.   62,    96.    153. 
180.  202.  247.  338,  344. 

cane,  60,  65,  66,  67,  68. 

classification  of.  59. 

fruit.  60.  62.  92. 

maple.  60.  338. 

with  milk.  174,  180. 
Sulphur,  11.  82.  85. 
Sweets.  181,  182. 

artificial.  66,  181. 

for  the  child,  66.  181,  182.  183. 

natural,  182.  183,  202. 
Synthesis,  13. 
Sirup,  338,  345. 

Karo,  315. 


352 


THE    HOME    DIETITIAN 


Sirup,  maple,  338,  34.~>. 
refiners',  90. 


Tannic  acid,  146,  1  17. 
Tannin,  146,  147. 
Tapioca,  330,  345. 
Taste  buds,  140. 
Tea,  146,  147,  339. 
Theine,  146,  147. 
Theobromine,  149. 
Thyroid  extract,  69. 

gland,  242. 
Toast,  cream  egg,  2!H. 

cream  puree  of  peas,  291. 

cream  tomato,  290. 

hot  buttered,  112. 

milk,  159. 

nut  cream,  291. 

oven,  290. 

prune  fluff,  290. 

zwieback,  290. 
Tomato,  48,  95,  104,  334,  345. 

and  lettuce  salad,  317. 

bisque,  300. 

canned,  78,  95,  179. 

jelly,  318. 

sandwich,  171. 

sauce,  314. 

soup,  297,  298,  2<»'.t. 
Tryptophane,  44. 
Trout,  332. 
Tuberculosis,  72,  259. 
Tubers,  99. 
Turkey,  332. 
Turnips,  334. 
Typhoid  fever,  230. 

Underfeeding,  29,  40,  188,  235,  259,  276. 
Urea,  19,  28. 
Uric  acid,  19,  28. 

Veal,  332. 

Vegetable  butter,  213,  216. 

oils,  54. 

oyster,  334,  345. 


Vegetables,    12,    46,    48,    76,    79,    87,    99- 
108,  129,   160,  202,  211,  220. 

classification  of,  99,  100. 

cooking  and  preparation,  105,  106. 

food  value  of,   48,   332,   340,   343,   344, 
345. 

for  children,  180,  184. 

proteins  of,  48,  99,  129,  207. 

raw,  79,  104,  196. 

vitamines  in,  76,  77,  99. 
Vegetarian  consomme,  252,  301. 
Vegetarians,  40,  138,  205. 
Vegex,  302. 
Vinegar,  142. 

Vitamines,  50,  53,   73,  77,   100,   103,   120, 
121,  265. 

beriberi,  73. 

fat-soluble  A,  73. 

relation  to  carbohydrate,  75. 

relation  to  protein,  75. 

scurvy,  73. 

source  of,  76. 

water-soluble,  73. 
Voit  standard  of  protein,  233. 

Walnuts,  338,  342. 
Water,  12,  13,  18,  32,  230. 

cress,  345. 

drinking  at  meals,  177. 

in  green  vegetables,  101. 
Watermelon,  335. 
Water-soluble  B,  73. 
Wheat,  cracked,  330,  345. 

cream  of,  330,  345. 

flakes,  330. 

grits,  330. 

home-ground,  110,  289. 

protein  of,  44,  47.  |el 
Whole-wheat  bread,  329. 

flour,  341. 

gems,  285. 

sticks,  287. 

Yogurt,  194,  267,  331. 

Zein,  44. 

Zwieback,  111,  290.     See  also  Oven  toast. 


THIS  BOOK  IS  DUE  ON  THE  LAST  DATE 
STAMPED  BELOW 


AN     INITIAL    FINE    OF    25    CENTS 

WILL  BE  ASSESSED  FOR  FAILURE  TO  RETURN 
THIS  BOOK  ON  THE  DATE  DUE.  THE  PENALTY 
WILL  INCREASE  TO  SO  CENTS  ON  THE  FOURTH 
DAY  AND  TO  $1.OO  ON  THE  SEVENTH  DAY 
OVERDUE. 


MAR   7  1933 
JAN    41937 

S£p    21  193£ 

14May'56VLl 


Ift 
SENT  ON  ILL 

SEP  1  3  ?006 

U.C.BERKELEY 


LD  21-50m-l,'33 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 


